How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $38.90 Median $47.86 Typical High $112.20 | Facility | None | $38.90 | $47.86 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $44.67 | Professional | None | $38.90 | $38.90 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
CDPHP Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $85.11 Typical High $181.97 | Facility | None | $47.86 | $85.11 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $251.19 | Professional | None | $47.86 | $47.86 | $251.19 |
Emblem Health Setting Facility Modifier None Typical Low $117.49 Median $263.03 Typical High $416.87 | Facility | None | $117.49 | $263.03 | $416.87 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $363.08 Typical High $446.68 | Professional | None | $338.84 | $363.08 | $446.68 |
Excellus BCBS Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $363.08 | Facility | None | $48.98 | $48.98 | $363.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $363.08 | Professional | None | $48.98 | $48.98 | $363.08 |
MVP Health Care Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
United Setting Professional Modifier None Typical Low $46.77 Median $48.98 Typical High $269.15 | Professional | None | $46.77 | $48.98 | $269.15 |
Univera Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $363.08 | Facility | None | $48.98 | $48.98 | $363.08 |
Univera Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $363.08 | Professional | None | $48.98 | $48.98 | $363.08 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $19.50 Typical High $22.39 | Professional | 52 · Reduced service | $19.50 | $19.50 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $7.76 Typical High $8.91 | Professional | 53 · Discontinued | $7.76 | $7.76 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $6.76 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $4.47 |
Where New York sits
The same service costs 3.9 times more in Hawaii than in South Carolina. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 34th of 51
$47.86
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.