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 $52.48 Median $53.70 Typical High $97.72 | Facility | None | $52.48 | $53.70 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $54.95 | Facility | None | $52.48 | $52.48 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $109.65 | Professional | None | $52.48 | $52.48 | $109.65 |
CDPHP Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $57.54 Typical High $85.11 | Facility | None | $47.86 | $57.54 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $223.87 | Professional | None | $47.86 | $47.86 | $223.87 |
Emblem Health Setting Facility Modifier None Typical Low $45.71 Median $54.95 Typical High $112.20 | Facility | None | $45.71 | $54.95 | $112.20 |
Emblem Health Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $97.72 | Professional | None | $50.12 | $57.54 | $97.72 |
Excellus BCBS Setting Facility Modifier None Typical Low $47.86 Median $52.48 Typical High $52.48 | Facility | None | $47.86 | $52.48 | $52.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $47.86 Median $51.29 Typical High $52.48 | Professional | None | $47.86 | $51.29 | $52.48 |
Highmark BCBS Setting Facility Modifier None Typical Low $28.18 Median $29.51 Typical High $47.86 | Facility | None | $28.18 | $29.51 | $47.86 |
MVP Health Care Setting Facility Modifier None Typical Low $58.88 Median $67.61 Typical High $102.33 | Facility | None | $58.88 | $67.61 | $102.33 |
MVP Health Care Setting Professional Modifier None Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | None | $57.54 | $67.61 | $67.61 |
United Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $52.48 Median $56.23 Typical High $74.13 | Professional | None | $52.48 | $56.23 | $74.13 |
Univera Setting Facility Modifier None Typical Low $47.86 Median $52.48 Typical High $52.48 | Facility | None | $47.86 | $52.48 | $52.48 |
Univera Setting Professional Modifier None Typical Low $47.86 Median $51.29 Typical High $58.88 | Professional | None | $47.86 | $51.29 | $58.88 |
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 $26.30 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
Where New York sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 36th 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.