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 $40.74 Median $53.70 Typical High $117.49 | Facility | None | $40.74 | $53.70 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | None | $40.74 | $40.74 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $74.13 | Professional | None | $48.98 | $48.98 | $74.13 |
CDPHP Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $54.95 Typical High $77.62 | Facility | None | $52.48 | $54.95 | $77.62 |
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 $48.98 Median $60.26 Typical High $112.20 | Facility | None | $48.98 | $60.26 | $112.20 |
Emblem Health Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $53.70 | Professional | None | $50.12 | $50.12 | $53.70 |
United Setting Professional Modifier None Typical Low $58.88 Median $61.66 Typical High $79.43 | Professional | None | $58.88 | $61.66 | $79.43 |
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 $20.42 Median $20.42 Typical High $23.44 | Professional | 52 · Reduced service | $20.42 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $9.33 | Professional | 53 · Discontinued | $8.13 | $8.13 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $7.08 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.68 |
Where New York sits
The same service costs 1.6 times more in Alaska than in Pennsylvania. 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· 28th 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.