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 $20.42 Median $24.55 Typical High $93.33 | Facility | None | $20.42 | $24.55 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $33.11 | Facility | None | $32.36 | $32.36 | $33.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | None | $20.42 | $20.42 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $26.92 Typical High $42.66 | Facility | None | $22.39 | $26.92 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $138.04 | Professional | None | $20.42 | $20.42 | $138.04 |
Emblem Health Setting Facility Modifier None Typical Low $19.05 Median $22.91 Typical High $69.18 | Facility | None | $19.05 | $22.91 | $69.18 |
Emblem Health Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $93.33 | Professional | None | $20.42 | $20.42 | $93.33 |
Excellus BCBS Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Excellus BCBS Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
MVP Health Care Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $162.18 | Facility | None | $31.62 | $31.62 | $162.18 |
MVP Health Care Setting Professional Modifier None Typical Low $30.90 Median $46.77 Typical High $70.79 | Professional | None | $30.90 | $46.77 | $70.79 |
United Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $48.98 | Professional | None | $32.36 | $33.88 | $48.98 |
Univera Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $33.88 | Facility | None | $32.36 | $32.36 | $33.88 |
Univera Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.90 | Professional | None | $32.36 | $32.36 | $38.90 |
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 $10.23 Median $10.23 Typical High $10.23 | Professional | 52 · Reduced service | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | 55 · Aftercare only | $3.02 | $3.02 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.04 Typical High $2.04 | Professional | 56 · Pre-op care only | $2.04 | $2.04 | $2.04 |
Where New York sits
The same service costs 3.8 times more in Oklahoma than in Delaware. 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· 42nd of 51
$24.55
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.