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 $23.44 Median $34.67 Typical High $67.61 | Facility | None | $23.44 | $34.67 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $26.92 | Professional | None | $23.44 | $23.44 | $26.92 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $61.66 | Professional | None | $28.18 | $28.18 | $61.66 |
CDPHP Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $85.11 | Facility | None | $31.62 | $31.62 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Emblem Health Setting Facility Modifier None Typical Low $28.18 Median $32.36 Typical High $63.10 | Facility | None | $28.18 | $32.36 | $63.10 |
Emblem Health Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $36.31 | Professional | None | $28.84 | $28.84 | $36.31 |
MVP Health Care Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
MVP Health Care Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
United Setting Professional Modifier None Typical Low $33.88 Median $34.67 Typical High $46.77 | Professional | None | $33.88 | $34.67 | $46.77 |
Univera Setting Facility Modifier None Typical Low $30.90 Median $40.74 Typical High $40.74 | Facility | None | $30.90 | $40.74 | $40.74 |
Univera Setting Professional Modifier None Typical Low $30.90 Median $40.74 Typical High $40.74 | Professional | None | $30.90 | $40.74 | $40.74 |
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 $11.75 Median $11.75 Typical High $13.49 | Professional | 52 · Reduced service | $11.75 | $11.75 | $13.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $4.68 Typical High $5.50 | Professional | 53 · Discontinued | $4.68 | $4.68 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $4.07 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $2.69 | Professional | 56 · Pre-op care only | $2.34 | $2.34 | $2.69 |
Where New York sits
The same service costs 1.7 times more in Arizona than in Oklahoma. 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· 42nd of 51
$28.84
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.