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 $28.84 Median $37.15 Typical High $83.18 | Facility | None | $28.84 | $37.15 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $29.51 | Facility | None | $28.84 | $28.84 | $29.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $29.51 Typical High $29.51 | Professional | None | $23.99 | $29.51 | $29.51 |
CDPHP Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $38.90 Typical High $53.70 | Facility | None | $25.12 | $38.90 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $120.23 | Professional | None | $29.51 | $29.51 | $120.23 |
Emblem Health Setting Facility Modifier None Typical Low $28.18 Median $33.88 Typical High $63.10 | Facility | None | $28.18 | $33.88 | $63.10 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $38.02 | Professional | None | $30.90 | $30.90 | $38.02 |
Excellus BCBS Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $29.51 | Facility | None | $28.84 | $28.84 | $29.51 |
Excellus BCBS Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $29.51 | Professional | None | $28.84 | $28.84 | $29.51 |
MVP Health Care Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $63.10 | Facility | None | $36.31 | $36.31 | $63.10 |
MVP Health Care Setting Professional Modifier None Typical Low $29.51 Median $36.31 Typical High $36.31 | Professional | None | $29.51 | $36.31 | $36.31 |
United Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
United Setting Professional Modifier None Typical Low $28.84 Median $30.20 Typical High $38.90 | Professional | None | $28.84 | $30.20 | $38.90 |
Univera Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $30.20 | Facility | None | $28.84 | $28.84 | $30.20 |
Univera Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $29.51 | Professional | None | $28.84 | $28.84 | $29.51 |
5 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 $14.79 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 54 · Surgery only | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $2.95 |
Where New York sits
The same service costs 1.9 times more in Alaska than in Oklahoma. 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· 24th of 51
$29.51
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.