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 $43.65 Median $51.29 Typical High $128.82 | Facility | None | $43.65 | $51.29 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $51.29 | Professional | None | $43.65 | $43.65 | $51.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $104.71 | Professional | None | $52.48 | $52.48 | $104.71 |
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 $51.29 Median $51.29 Typical High $85.11 | Facility | None | $51.29 | $51.29 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $288.40 | Professional | None | $53.70 | $53.70 | $288.40 |
Emblem Health Setting Facility Modifier None Typical Low $52.48 Median $58.88 Typical High $93.33 | Facility | None | $52.48 | $58.88 | $93.33 |
Emblem Health Setting Professional Modifier None Typical Low $44.67 Median $85.11 Typical High $128.82 | Professional | None | $44.67 | $85.11 | $128.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
MVP Health Care Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
United Setting Facility Modifier None Typical Low $69.18 Median $81.28 Typical High $100.00 | Facility | None | $69.18 | $81.28 | $100.00 |
United Setting Professional Modifier None Typical Low $52.48 Median $56.23 Typical High $72.44 | Professional | None | $52.48 | $56.23 | $72.44 |
Univera Setting Facility Modifier None Typical Low $38.02 Median $43.65 Typical High $43.65 | Facility | None | $38.02 | $43.65 | $43.65 |
Univera Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $43.65 | Professional | None | $28.84 | $28.84 | $43.65 |
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 $21.88 Median $21.88 Typical High $25.12 | Professional | 52 · Reduced service | $21.88 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $10.23 | Professional | 53 · Discontinued | $8.71 | $8.71 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $7.59 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $5.13 |
Where New York sits
The same service costs 6.6 times more in Alabama than in Kansas. 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· 37th 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.