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 $33.11 Median $48.98 Typical High $95.50 | Facility | None | $33.11 | $48.98 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $38.02 | Professional | None | $33.11 | $33.11 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $39.81 | Facility | None | $38.02 | $38.02 | $39.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $45.71 Typical High $70.79 | Facility | None | $40.74 | $45.71 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $213.80 | Professional | None | $40.74 | $40.74 | $213.80 |
Emblem Health Setting Facility Modifier None Typical Low $28.18 Median $40.74 Typical High $83.18 | Facility | None | $28.18 | $40.74 | $83.18 |
Emblem Health Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $51.29 | Professional | None | $40.74 | $40.74 | $51.29 |
Excellus BCBS Setting Facility Modifier None Typical Low $39.81 Median $42.66 Typical High $42.66 | Facility | None | $39.81 | $42.66 | $42.66 |
Excellus BCBS Setting Professional Modifier None Typical Low $39.81 Median $42.66 Typical High $42.66 | Professional | None | $39.81 | $42.66 | $42.66 |
MVP Health Care Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
MVP Health Care Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $39.81 Median $42.66 Typical High $54.95 | Professional | None | $39.81 | $42.66 | $54.95 |
Univera Setting Facility Modifier None Typical Low $39.81 Median $42.66 Typical High $42.66 | Facility | None | $39.81 | $42.66 | $42.66 |
Univera Setting Professional Modifier None Typical Low $39.81 Median $42.66 Typical High $42.66 | Professional | None | $39.81 | $42.66 | $42.66 |
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 $16.60 Median $16.60 Typical High $19.05 | Professional | 52 · Reduced service | $16.60 | $16.60 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $7.59 | Professional | 53 · Discontinued | $6.61 | $6.61 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $5.75 | Professional | 55 · Aftercare only | $5.01 | $5.01 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.31 | $3.31 | $3.80 |
Where New York sits
The same service costs 1.8 times more in Alaska than in Nebraska. 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· 45th of 51
$39.81
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.