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 $18.62 Median $23.99 Typical High $53.70 | Facility | None | $18.62 | $23.99 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $24.55 | Professional | None | $19.50 | $19.50 | $24.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $19.05 | Facility | None | $18.62 | $18.62 | $19.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
CDPHP Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $19.05 Median $24.55 Typical High $28.84 | Facility | None | $19.05 | $24.55 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $79.43 | Professional | None | $19.50 | $19.50 | $79.43 |
Emblem Health Setting Facility Modifier None Typical Low $18.20 Median $21.88 Typical High $40.74 | Facility | None | $18.20 | $21.88 | $40.74 |
Emblem Health Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $28.18 | Professional | None | $19.95 | $19.95 | $28.18 |
Excellus BCBS Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
Excellus BCBS Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
MVP Health Care Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $46.77 | Facility | None | $23.44 | $23.44 | $46.77 |
MVP Health Care Setting Professional Modifier None Typical Low $18.20 Median $22.39 Typical High $25.70 | Professional | None | $18.20 | $22.39 | $25.70 |
United Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
United Setting Professional Modifier None Typical Low $18.62 Median $19.95 Typical High $26.30 | Professional | None | $18.62 | $19.95 | $26.30 |
Univera Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $20.42 | Facility | None | $18.62 | $18.62 | $20.42 |
Univera Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $22.39 | Professional | None | $18.62 | $18.62 | $22.39 |
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 $9.55 Median $9.55 Typical High $9.55 | Professional | 52 · Reduced service | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 53 · Discontinued | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $2.88 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $1.95 |
Where New York sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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· 38th of 51
$19.50
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.