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 $257.04 Median $338.84 Typical High $741.31 | Facility | None | $257.04 | $338.84 | $741.31 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $295.12 | Professional | None | $257.04 | $257.04 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.02 Median $331.13 Typical High $467.74 | Professional | None | $0.02 | $331.13 | $467.74 |
CDPHP Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $338.84 Typical High $478.63 | Facility | None | $177.83 | $338.84 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Emblem Health Setting Facility Modifier None Typical Low $302.00 Median $346.74 Typical High $676.08 | Facility | None | $302.00 | $346.74 | $676.08 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | None | $338.84 | $346.74 | $346.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
MVP Health Care Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
United Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $416.87 | Professional | None | $309.03 | $331.13 | $416.87 |
Univera Setting Facility Modifier None Typical Low $162.18 Median $165.96 Typical High $165.96 | Facility | None | $162.18 | $165.96 | $165.96 |
Univera Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $165.96 | Professional | None | $97.72 | $165.96 | $165.96 |
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 $128.82 Median $128.82 Typical High $147.91 | Professional | 52 · Reduced service | $128.82 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $58.88 | Professional | 53 · Discontinued | $51.29 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $44.67 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $29.51 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $29.51 |
Where New York sits
The same service costs 2.3 times more in Alaska than in Montana. 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· 49th of 51
$309
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.