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 $74.13 Median $97.72 Typical High $223.87 | Facility | None | $74.13 | $97.72 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $77.62 | Facility | None | $75.86 | $75.86 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $100.00 Typical High $112.20 | Facility | None | $81.28 | $100.00 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $323.59 | Professional | None | $74.13 | $74.13 | $323.59 |
Emblem Health Setting Facility Modifier None Typical Low $70.79 Median $81.28 Typical High $257.04 | Facility | None | $70.79 | $81.28 | $257.04 |
Emblem Health Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $102.33 | Professional | None | $70.79 | $70.79 | $102.33 |
Excellus BCBS Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $77.62 | Facility | None | $75.86 | $75.86 | $77.62 |
Excellus BCBS Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | None | $75.86 | $75.86 | $77.62 |
MVP Health Care Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $173.78 | Facility | None | $100.00 | $100.00 | $173.78 |
MVP Health Care Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $117.49 | Professional | None | $81.28 | $100.00 | $117.49 |
United Setting Professional Modifier None Typical Low $75.86 Median $81.28 Typical High $107.15 | Professional | None | $75.86 | $81.28 | $107.15 |
Univera Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $79.43 | Facility | None | $75.86 | $75.86 | $79.43 |
Univera Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | None | $75.86 | $75.86 | $77.62 |
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 $37.15 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 53 · Discontinued | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $7.41 |
Where New York sits
The same service costs 1.5 times more in Alaska 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· 35th of 51
$75.86
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.