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 $102.33 Median $128.82 Typical High $302.00 | Facility | None | $102.33 | $128.82 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | None | $102.33 | $102.33 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $134.90 | Facility | None | $131.83 | $131.83 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
CDPHP Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $223.87 Typical High $295.12 | Facility | None | $128.82 | $223.87 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $676.08 | Professional | None | $128.82 | $128.82 | $676.08 |
Emblem Health Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $208.93 | Facility | None | $128.82 | $128.82 | $208.93 |
Emblem Health Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $158.49 | Professional | None | $128.82 | $128.82 | $158.49 |
Excellus BCBS Setting Facility Modifier None Typical Low $128.82 Median $131.83 Typical High $131.83 | Facility | None | $128.82 | $131.83 | $131.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | None | $128.82 | $131.83 | $131.83 |
MVP Health Care Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $125.89 Median $131.83 Typical High $190.55 | Professional | None | $125.89 | $131.83 | $190.55 |
Univera Setting Facility Modifier None Typical Low $128.82 Median $131.83 Typical High $131.83 | Facility | None | $128.82 | $131.83 | $131.83 |
Univera Setting Professional Modifier None Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | None | $128.82 | $131.83 | $131.83 |
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 $51.29 Median $51.29 Typical High $60.26 | Professional | 52 · Reduced service | $51.29 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $23.99 | Professional | 53 · Discontinued | $20.89 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $18.20 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $12.02 |
Where New York sits
The same service costs 2.3 times more in Texas than in Hawaii. 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· 41st of 51
$126
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.