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 $18.20 Median $22.39 Typical High $56.23 | Facility | None | $18.20 | $22.39 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.95 | Facility | None | $19.50 | $19.50 | $19.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
CDPHP Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $19.95 Median $25.70 Typical High $43.65 | Facility | None | $19.95 | $25.70 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $83.18 | Professional | None | $18.20 | $18.20 | $83.18 |
Emblem Health Setting Facility Modifier None Typical Low $16.98 Median $20.42 Typical High $61.66 | Facility | None | $16.98 | $20.42 | $61.66 |
Emblem Health Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $40.74 | Professional | None | $18.20 | $18.20 | $40.74 |
Excellus BCBS Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.95 | Facility | None | $19.50 | $19.50 | $19.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.95 | Professional | None | $19.50 | $19.50 | $19.95 |
MVP Health Care Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $70.79 | Facility | None | $22.39 | $22.39 | $70.79 |
MVP Health Care Setting Professional Modifier None Typical Low $17.78 Median $21.88 Typical High $23.99 | Professional | None | $17.78 | $21.88 | $23.99 |
United Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
United Setting Professional Modifier None Typical Low $19.50 Median $26.30 Typical High $38.02 | Professional | None | $19.50 | $26.30 | $38.02 |
Univera Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $20.42 | Facility | None | $19.50 | $19.50 | $20.42 |
Univera Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.95 | Professional | None | $19.50 | $19.50 | $19.95 |
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 $9.12 Median $9.12 Typical High $9.12 | Professional | 52 · Reduced service | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $3.63 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $1.82 |
Where New York sits
The same service costs 2.1 times more in Oklahoma than in Florida. 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· 37th of 51
$19.50
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.