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 $30.90 Median $37.15 Typical High $91.20 | Facility | None | $30.90 | $37.15 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $36.31 | Professional | None | $30.90 | $30.90 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
CDPHP Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $1.35 Median $1.35 Typical High $85.11 | Facility | None | $1.35 | $1.35 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $204.17 | Professional | None | $38.02 | $38.02 | $204.17 |
Emblem Health Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $61.66 | Facility | None | $38.02 | $38.02 | $61.66 |
Emblem Health Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $46.77 | Professional | None | $38.02 | $38.02 | $46.77 |
Excellus BCBS Setting Facility Modifier None Typical Low $38.02 Median $38.90 Typical High $38.90 | Facility | None | $38.02 | $38.90 | $38.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $38.02 Median $38.90 Typical High $38.90 | Professional | None | $38.02 | $38.90 | $38.90 |
Highmark BCBS Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
MVP Health Care Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
MVP Health Care Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | None | $8.91 | $8.91 | $8.91 |
United Setting Professional Modifier None Typical Low $37.15 Median $39.81 Typical High $53.70 | Professional | None | $37.15 | $39.81 | $53.70 |
Univera Setting Facility Modifier None Typical Low $38.02 Median $38.90 Typical High $38.90 | Facility | None | $38.02 | $38.90 | $38.90 |
Univera Setting Professional Modifier None Typical Low $1.35 Median $38.90 Typical High $38.90 | Professional | None | $1.35 | $38.90 | $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 $15.49 Median $15.49 Typical High $18.20 | Professional | 52 · Reduced service | $15.49 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $7.24 | Professional | 53 · Discontinued | $6.17 | $6.17 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $5.37 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.63 |
Where New York sits
The same service costs 20.4 times more in Arizona than in Hawaii. 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· 30th of 51
$37.15
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.