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 $41.69 Median $50.12 Typical High $120.23 | Facility | None | $41.69 | $50.12 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $48.98 | Professional | None | $41.69 | $41.69 | $48.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $50.12 Typical High $50.12 | Professional | None | $38.90 | $50.12 | $50.12 |
CDPHP Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Cigna Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $85.11 | Facility | None | $19.95 | $19.95 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Emblem Health Setting Facility Modifier None Typical Low $8.32 Median $32.36 Typical High $61.66 | Facility | None | $8.32 | $32.36 | $61.66 |
Emblem Health Setting Professional Modifier None Typical Low $13.49 Median $53.70 Typical High $53.70 | Professional | None | $13.49 | $53.70 | $53.70 |
Excellus BCBS Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Excellus BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
MVP Health Care Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
MVP Health Care Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $67.61 | Professional | None | $50.12 | $52.48 | $67.61 |
Univera Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Univera Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
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 $20.89 Median $20.89 Typical High $24.55 | Professional | 52 · Reduced service | $20.89 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $9.77 | Professional | 53 · Discontinued | $8.51 | $8.51 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $7.41 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $4.90 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $4.90 |
Where New York sits
The same service costs 6.6 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· 16th of 51
$52.48
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.