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 $38.02 Median $51.29 Typical High $114.82 | Facility | None | $38.02 | $51.29 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
CDPHP Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $50.12 Typical High $69.18 | Facility | None | $40.74 | $50.12 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Emblem Health Setting Facility Modifier None Typical Low $36.31 Median $45.71 Typical High $85.11 | Facility | None | $36.31 | $45.71 | $85.11 |
Emblem Health Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Excellus BCBS Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $41.69 | Facility | None | $39.81 | $39.81 | $41.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $41.69 | Professional | None | $39.81 | $39.81 | $41.69 |
MVP Health Care Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $112.20 | Facility | None | $47.86 | $47.86 | $112.20 |
MVP Health Care Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
United Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $53.70 | Professional | None | $39.81 | $41.69 | $53.70 |
Univera Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $47.86 | Facility | None | $39.81 | $39.81 | $47.86 |
Univera Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $41.69 | Professional | None | $39.81 | $41.69 | $41.69 |
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 $19.05 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.80 |
Where New York sits
The same service costs 1.6 times more in Alaska than in South Carolina. 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· 14th of 51
$39.81
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.