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 $295.12 Median $316.23 Typical High $323.59 | Facility | None | $295.12 | $316.23 | $323.59 |
Aetna Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $316.23 | Professional | None | $6.61 | $6.61 | $316.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $151.36 | Professional | None | $114.82 | $134.90 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Highmark BCBS Setting Facility Modifier None Typical Low $154.88 Median $257.04 Typical High $602.56 | Facility | None | $154.88 | $257.04 | $602.56 |
MVP Health Care Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $257.04 | Professional | None | $123.03 | $147.91 | $257.04 |
United Setting Facility Modifier None Typical Low $363.08 Median $426.58 Typical High $524.81 | Facility | None | $363.08 | $426.58 | $524.81 |
United Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Univera Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $398.11 | Facility | None | $144.54 | $151.36 | $398.11 |
Univera Setting Professional Modifier None Typical Low $91.20 Median $151.36 Typical High $151.36 | Professional | None | $91.20 | $151.36 | $151.36 |
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 $3.31 Median $3.31 Typical High $158.49 | Professional | 52 · Reduced service | $3.31 | $3.31 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $43.65 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $33.11 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $21.88 | $31.62 | $31.62 |
Where New York sits
The same service costs 5.2 times more in Alaska than in Georgia. 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
$135
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.