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 $31.62 Median $40.74 Typical High $91.20 | Facility | None | $31.62 | $40.74 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $33.11 | Professional | None | $31.62 | $31.62 | $33.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $44.67 | Professional | None | $31.62 | $31.62 | $44.67 |
CDPHP Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $41.69 Typical High $57.54 | Facility | None | $22.39 | $41.69 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $134.90 | Professional | None | $31.62 | $31.62 | $134.90 |
Emblem Health Setting Facility Modifier None Typical Low $30.20 Median $34.67 Typical High $67.61 | Facility | None | $30.20 | $34.67 | $67.61 |
Emblem Health Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $70.79 | Professional | None | $31.62 | $31.62 | $70.79 |
Excellus BCBS Setting Facility Modifier None Typical Low $33.11 Median $56.23 Typical High $56.23 | Facility | None | $33.11 | $56.23 | $56.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $33.11 Median $56.23 Typical High $56.23 | Professional | None | $33.11 | $56.23 | $56.23 |
MVP Health Care Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $123.03 | Facility | None | $40.74 | $40.74 | $123.03 |
MVP Health Care Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
United Setting Professional Modifier None Typical Low $31.62 Median $33.11 Typical High $64.57 | Professional | None | $31.62 | $33.11 | $64.57 |
Univera Setting Facility Modifier None Typical Low $33.11 Median $56.23 Typical High $56.23 | Facility | None | $33.11 | $56.23 | $56.23 |
Univera Setting Professional Modifier None Typical Low $22.39 Median $56.23 Typical High $56.23 | Professional | None | $22.39 | $56.23 | $56.23 |
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 $15.85 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $3.16 |
Where New York sits
The same service costs 3.8 times more in Alabama than in Virginia. 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· 46th of 51
$31.62
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.