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 $72.44 Median $87.10 Typical High $213.80 | Facility | None | $72.44 | $87.10 | $213.80 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $75.86 | Professional | None | $72.44 | $72.44 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $131.83 | Professional | None | $72.44 | $72.44 | $131.83 |
CDPHP Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $107.15 Typical High $120.23 | Facility | None | $79.43 | $107.15 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $95.50 | Professional | None | $72.44 | $72.44 | $95.50 |
Emblem Health Setting Facility Modifier None Typical Low $69.18 Median $87.10 Typical High $162.18 | Facility | None | $69.18 | $87.10 | $162.18 |
Emblem Health Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $154.88 | Professional | None | $63.10 | $79.43 | $154.88 |
Excellus BCBS Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $75.86 | Facility | None | $74.13 | $74.13 | $75.86 |
Excellus BCBS Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | None | $74.13 | $75.86 | $75.86 |
Highmark BCBS Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
MVP Health Care Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $204.17 | Facility | None | $104.71 | $104.71 | $204.17 |
MVP Health Care Setting Professional Modifier None Typical Low $102.33 Median $109.65 Typical High $109.65 | Professional | None | $102.33 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $29.51 Median $74.13 Typical High $112.20 | Professional | None | $29.51 | $74.13 | $112.20 |
Univera Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $77.62 | Facility | None | $74.13 | $74.13 | $77.62 |
Univera Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $75.86 | Professional | None | $74.13 | $75.86 | $75.86 |
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 $36.31 Median $36.31 Typical High $37.15 | Professional | 52 · Reduced service | $36.31 | $36.31 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $14.79 | Professional | 53 · Discontinued | $14.45 | $14.45 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $11.22 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $7.41 |
Where New York sits
The same service costs 1.6 times more in Hawaii 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· 21st of 51
$74.13
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.