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 $389.05 Median $478.63 Typical High $1,122.02 | Facility | None | $389.05 | $478.63 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | None | $389.05 | $389.05 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $1,000.00 | Professional | None | $426.58 | $467.74 | $1,000.00 |
CDPHP Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $489.78 Typical High $707.95 | Facility | None | $158.49 | $489.78 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | None | $478.63 | $478.63 | $562.34 |
Emblem Health Setting Facility Modifier None Typical Low $467.74 Median $537.03 Typical High $1,047.13 | Facility | None | $467.74 | $537.03 | $1,047.13 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $588.84 | Professional | None | $478.63 | $478.63 | $588.84 |
MVP Health Care Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
United Setting Professional Modifier None Typical Low $467.74 Median $489.78 Typical High $630.96 | Professional | None | $467.74 | $489.78 | $630.96 |
Univera Setting Facility Modifier None Typical Low $154.88 Median $186.21 Typical High $186.21 | Facility | None | $154.88 | $186.21 | $186.21 |
Univera Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | None | $154.88 | $186.21 | $186.21 |
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 $194.98 Median $194.98 Typical High $223.87 | Professional | 52 · Reduced service | $194.98 | $194.98 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $89.13 | Professional | 53 · Discontinued | $77.62 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $67.61 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $44.67 |
Where New York sits
The same service costs 2.3 times more in Arizona than in Idaho. 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· 39th of 51
$468
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.