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 $104.71 Median $154.88 Typical High $354.81 | Facility | None | $104.71 | $154.88 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $123.03 | Facility | None | $120.23 | $120.23 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
CDPHP Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $151.36 Typical High $346.74 | Facility | None | $114.82 | $151.36 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Emblem Health Setting Facility Modifier None Typical Low $100.00 Median $128.82 Typical High $380.19 | Facility | None | $100.00 | $128.82 | $380.19 |
Emblem Health Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Excellus BCBS Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $125.89 | Facility | None | $120.23 | $120.23 | $125.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $125.89 | Professional | None | $120.23 | $120.23 | $125.89 |
MVP Health Care Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $436.52 | Facility | None | $138.04 | $138.04 | $436.52 |
MVP Health Care Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
United Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $162.18 | Professional | None | $120.23 | $128.82 | $162.18 |
Univera Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $125.89 | Facility | None | $120.23 | $120.23 | $125.89 |
Univera Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | None | $120.23 | $125.89 | $125.89 |
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 $52.48 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.47 |
Where New York sits
The same service costs 1.9 times more in Wyoming than in Vermont. 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· 18th of 51
$120
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.