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 $44.67 Median $54.95 Typical High $128.82 | Facility | None | $44.67 | $54.95 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $51.29 | Professional | None | $44.67 | $44.67 | $51.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $53.70 | Professional | None | $37.15 | $53.70 | $53.70 |
CDPHP Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $38.90 Typical High $85.11 | Facility | None | $32.36 | $38.90 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $288.40 | Professional | None | $54.95 | $54.95 | $288.40 |
Emblem Health Setting Facility Modifier None Typical Low $33.11 Median $38.90 Typical High $75.86 | Facility | None | $33.11 | $38.90 | $75.86 |
Emblem Health Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $42.66 | Professional | None | $33.88 | $33.88 | $42.66 |
MVP Health Care Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
MVP Health Care Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $36.31 | Professional | None | $3.98 | $3.98 | $36.31 |
United Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $74.13 | Professional | None | $48.98 | $57.54 | $74.13 |
Univera Setting Facility Modifier None Typical Low $11.48 Median $15.14 Typical High $15.14 | Facility | None | $11.48 | $15.14 | $15.14 |
Univera Setting Professional Modifier None Typical Low $11.48 Median $15.14 Typical High $15.49 | Professional | None | $11.48 | $15.14 | $15.49 |
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 $22.39 Median $22.39 Typical High $25.70 | Professional | 52 · Reduced service | $22.39 | $22.39 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $10.47 | Professional | 53 · Discontinued | $8.91 | $8.91 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $7.76 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $5.13 |
Where New York sits
The same service costs 2.2 times more in Alaska than in Montana. 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· 35th of 51
$53.70
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.