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 $24.55 Typical High $52.48 | Facility | None | $18.20 | $24.55 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | None | $18.20 | $18.20 | $21.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.99 | Facility | None | $23.44 | $23.44 | $23.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $34.67 | Professional | None | $21.88 | $21.88 | $34.67 |
CDPHP Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $60.26 | Facility | None | $24.55 | $24.55 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Emblem Health Setting Facility Modifier None Typical Low $21.88 Median $25.12 Typical High $50.12 | Facility | None | $21.88 | $25.12 | $50.12 |
Emblem Health Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $24.55 | Professional | None | $22.39 | $22.39 | $24.55 |
Excellus BCBS Setting Facility Modifier None Typical Low $22.39 Median $23.44 Typical High $23.44 | Facility | None | $22.39 | $23.44 | $23.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $22.39 Median $23.44 Typical High $23.44 | Professional | None | $22.39 | $23.44 | $23.44 |
MVP Health Care Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
MVP Health Care Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $25.70 | Professional | None | $23.44 | $23.44 | $25.70 |
United Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
United Setting Professional Modifier None Typical Low $21.88 Median $23.44 Typical High $29.51 | Professional | None | $21.88 | $23.44 | $29.51 |
Univera Setting Facility Modifier None Typical Low $22.39 Median $23.44 Typical High $23.44 | Facility | None | $22.39 | $23.44 | $23.44 |
Univera Setting Professional Modifier None Typical Low $22.39 Median $23.44 Typical High $23.44 | Professional | None | $22.39 | $23.44 | $23.44 |
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 $10.47 | Professional | 52 · Reduced service | $9.12 | $9.12 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $4.27 | Professional | 53 · Discontinued | $3.63 | $3.63 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $3.16 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $2.14 |
Where New York sits
The same service costs 1.5 times more in Alaska than in Arizona. 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· 41st of 51
$22.39
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.