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 $85.11 Median $104.71 Typical High $245.47 | Facility | None | $85.11 | $104.71 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $97.72 | Professional | None | $85.11 | $85.11 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.02 Median $91.20 Typical High $354.81 | Professional | None | $0.02 | $91.20 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $114.82 Typical High $162.18 | Facility | None | $85.11 | $114.82 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Professional | None | $107.15 | $107.15 | $131.83 |
Emblem Health Setting Facility Modifier None Typical Low $102.33 Median $128.82 Typical High $239.88 | Facility | None | $102.33 | $128.82 | $239.88 |
Emblem Health Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $102.33 | Professional | None | $22.91 | $22.91 | $102.33 |
MVP Health Care Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $151.36 | Professional | None | $3.02 | $3.02 | $151.36 |
United Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $165.96 | Professional | None | $123.03 | $123.03 | $165.96 |
Univera Setting Facility Modifier None Typical Low $10.23 Median $14.45 Typical High $14.45 | Facility | None | $10.23 | $14.45 | $14.45 |
Univera Setting Professional Modifier None Typical Low $10.23 Median $14.13 Typical High $14.45 | Professional | None | $10.23 | $14.13 | $14.45 |
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 $42.66 Median $42.66 Typical High $48.98 | Professional | 52 · Reduced service | $42.66 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $19.50 | Professional | 53 · Discontinued | $16.98 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $14.79 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $9.77 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $9.77 |
Where New York sits
The same service costs 3.9 times more in Alaska than in Montana. 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· 12th of 51
$123
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.