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 $25.12 Median $33.11 Typical High $72.44 | Facility | None | $25.12 | $33.11 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $28.84 | Professional | None | $25.12 | $25.12 | $28.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
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 $30.90 Median $32.36 Typical High $85.11 | Facility | None | $30.90 | $32.36 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Emblem Health Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $50.12 | Facility | None | $30.90 | $30.90 | $50.12 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Excellus BCBS Setting Facility Modifier None Typical Low $30.90 Median $31.62 Typical High $31.62 | Facility | None | $30.90 | $31.62 | $31.62 |
Excellus BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $31.62 | Professional | None | $30.90 | $30.90 | $31.62 |
MVP Health Care Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
MVP Health Care Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
United Setting Professional Modifier None Typical Low $30.20 Median $31.62 Typical High $39.81 | Professional | None | $30.20 | $31.62 | $39.81 |
Univera Setting Facility Modifier None Typical Low $30.90 Median $31.62 Typical High $31.62 | Facility | None | $30.90 | $31.62 | $31.62 |
Univera Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $31.62 | Professional | None | $30.90 | $30.90 | $31.62 |
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 $12.59 Median $12.59 Typical High $14.45 | Professional | 52 · Reduced service | $12.59 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.75 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $4.37 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $2.88 |
Where New York sits
The same service costs 4.7 times more in Alaska 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· 39th of 51
$30.20
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.