How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $2.45 Median $2.69 Typical High $36.31 | Facility | None | $2.45 | $2.69 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $36.31 | Professional | None | $2.57 | $2.57 | $36.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.29 Median $1.29 Typical High $18.20 | Professional | 52 · Reduced service | $1.29 | $1.29 | $18.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $30.20 Typical High $30.20 | Professional | None | $21.88 | $30.20 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $93.33 Median $95.50 Typical High $302.00 | Facility | None | $93.33 | $95.50 | $302.00 |
MVP Health Care Setting Professional Modifier None Typical Low $40.74 Median $48.98 Typical High $85.11 | Professional | None | $40.74 | $48.98 | $85.11 |
United Setting Facility Modifier None Typical Low $169.82 Median $199.53 Typical High $245.47 | Facility | None | $169.82 | $199.53 | $245.47 |
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 $74.13 Median $74.13 Typical High $199.53 | Facility | None | $74.13 | $74.13 | $199.53 |
Univera Setting Professional Modifier None Typical Low $44.67 Median $74.13 Typical High $74.13 | Professional | None | $44.67 | $74.13 | $74.13 |
3 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 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $47.86 | Professional | 53 · Discontinued | $7.24 | $7.24 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $35.48 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $23.99 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $23.99 |
Where New York sits
The same service costs 35.5 times more in Texas than in Kentucky. 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· 33rd of 51
$74.13
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.