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 $524.81 Median $676.08 Typical High $1,548.82 | Facility | None | $524.81 | $676.08 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $562.34 | Professional | None | $524.81 | $524.81 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $549.54 | Facility | None | $524.81 | $524.81 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
CDPHP Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $794.33 | Facility | None | $537.03 | $537.03 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $2,238.72 | Professional | None | $524.81 | $524.81 | $2,238.72 |
Emblem Health Setting Facility Modifier None Typical Low $501.19 Median $645.65 Typical High $1,258.93 | Facility | None | $501.19 | $645.65 | $1,258.93 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $660.69 | Professional | None | $616.60 | $616.60 | $660.69 |
Excellus BCBS Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $549.54 | Facility | None | $524.81 | $524.81 | $549.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $549.54 | Professional | None | $524.81 | $524.81 | $549.54 |
MVP Health Care Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $1,122.02 | Facility | None | $676.08 | $676.08 | $1,122.02 |
MVP Health Care Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $758.58 | Professional | None | $524.81 | $676.08 | $758.58 |
United Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
United Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $741.31 | Professional | None | $524.81 | $562.34 | $741.31 |
Univera Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $562.34 | Facility | None | $524.81 | $524.81 | $562.34 |
Univera Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $549.54 | Professional | None | $524.81 | $524.81 | $549.54 |
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 $263.03 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $52.48 |
Where New York sits
The same service costs 1.9 times more in Alaska 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
$525
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.