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 $89.13 Typical High $208.93 | Facility | None | $72.44 | $89.13 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $83.18 | Professional | None | $72.44 | $72.44 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $125.89 | Professional | None | $87.10 | $87.10 | $125.89 |
CDPHP Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $97.72 Typical High $131.83 | Facility | None | $89.13 | $97.72 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $467.74 | Professional | None | $89.13 | $89.13 | $467.74 |
Emblem Health Setting Facility Modifier None Typical Low $89.13 Median $97.72 Typical High $181.97 | Facility | None | $89.13 | $97.72 | $181.97 |
Emblem Health Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $109.65 | Professional | None | $89.13 | $89.13 | $109.65 |
Excellus BCBS Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $89.13 | Facility | None | $87.10 | $87.10 | $89.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $89.13 | Professional | None | $87.10 | $87.10 | $89.13 |
MVP Health Care Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
MVP Health Care Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
United Setting Professional Modifier None Typical Low $87.10 Median $91.20 Typical High $117.49 | Professional | None | $87.10 | $91.20 | $117.49 |
Univera Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $89.13 | Facility | None | $87.10 | $87.10 | $89.13 |
Univera Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | None | $87.10 | $87.10 | $95.50 |
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 $41.69 | Professional | 52 · Reduced service | $36.31 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $16.60 | Professional | 53 · Discontinued | $14.45 | $14.45 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $8.32 |
Where New York sits
The same service costs 1.6 times more in Alaska than in Texas. 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· 41st of 51
$87.10
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.