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 $1.74 Median $1.74 Typical High $81.28 | Facility | None | $1.74 | $1.74 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $81.28 | Professional | None | $1.74 | $1.74 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.87 Median $0.87 Typical High $40.74 | Professional | 52 · Reduced service | $0.87 | $0.87 | $40.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $645.65 | Professional | None | $104.71 | $141.25 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
MVP Health Care Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $190.55 | Professional | None | $91.20 | $109.65 | $190.55 |
United Setting Facility Modifier None Typical Low $295.12 Median $346.74 Typical High $426.58 | Facility | None | $295.12 | $346.74 | $426.58 |
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 $141.25 Median $141.25 Typical High $380.19 | Facility | None | $141.25 | $141.25 | $380.19 |
Univera Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $141.25 | Professional | None | $85.11 | $141.25 | $141.25 |
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 $11.48 Median $16.22 Typical High $18.20 | Professional | 53 · Discontinued | $11.48 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.02 Typical High $13.80 | Professional | 55 · Aftercare only | $8.71 | $12.02 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.13 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.75 | $8.13 | $9.12 |
Where New York sits
The same service costs 13.8 times more in Indiana 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· 44th of 51
$56.23
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.