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 $24.55 Median $31.62 Typical High $70.79 | Facility | None | $24.55 | $31.62 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $36.31 | Professional | None | $28.84 | $28.84 | $36.31 |
CDPHP Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $41.69 Typical High $52.48 | Facility | None | $31.62 | $41.69 | $52.48 |
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 $26.92 Median $34.67 Typical High $64.57 | Facility | None | $26.92 | $34.67 | $64.57 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $31.62 | Professional | None | $30.90 | $30.90 | $31.62 |
Excellus BCBS Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $25.70 | Facility | None | $24.55 | $24.55 | $25.70 |
Excellus BCBS Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $25.70 | Professional | None | $24.55 | $24.55 | $25.70 |
MVP Health Care Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $147.91 | Facility | None | $25.12 | $25.12 | $147.91 |
MVP Health Care Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $24.55 Median $26.30 Typical High $33.11 | Professional | None | $24.55 | $26.30 | $33.11 |
Univera Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $25.70 | Facility | None | $24.55 | $24.55 | $25.70 |
Univera Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $25.70 | Professional | None | $24.55 | $24.55 | $25.70 |
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 $14.45 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $2.88 |
Where New York sits
The same service costs 2.8 times more in Wyoming than in Arizona. 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· 30th 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.