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 $18.20 Median $18.62 Typical High $26.30 | Facility | None | $18.20 | $18.62 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $26.30 Typical High $26.30 | Professional | None | $18.20 | $26.30 | $26.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.50 Median $22.91 Typical High $31.62 | Professional | None | $19.50 | $22.91 | $31.62 |
CDPHP Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
Emblem Health Setting Facility Modifier None Typical Low $10.00 Median $28.18 Typical High $102.33 | Facility | None | $10.00 | $28.18 | $102.33 |
Emblem Health Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $45.71 | Professional | None | $30.90 | $30.90 | $45.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $20.89 Median $26.92 Typical High $34.67 | Professional | None | $20.89 | $26.92 | $34.67 |
MVP Health Care Setting Facility Modifier None Typical Low $25.70 Median $48.98 Typical High $134.90 | Facility | None | $25.70 | $48.98 | $134.90 |
MVP Health Care Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $58.88 | Professional | None | $22.39 | $22.39 | $58.88 |
United Setting Professional Modifier None Typical Low $18.62 Median $23.99 Typical High $48.98 | Professional | None | $18.62 | $23.99 | $48.98 |
Univera Setting Facility Modifier None Typical Low $24.55 Median $26.92 Typical High $31.62 | Facility | None | $24.55 | $26.92 | $31.62 |
Univera Setting Professional Modifier None Typical Low $20.89 Median $25.70 Typical High $34.67 | Professional | None | $20.89 | $25.70 | $34.67 |
5 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 $9.12 Median $13.18 Typical High $13.18 | Professional | 52 · Reduced service | $9.12 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $5.25 Typical High $5.25 | Professional | 53 · Discontinued | $3.63 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $3.98 Typical High $3.98 | Professional | 55 · Aftercare only | $2.75 | $3.98 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.63 Typical High $2.63 | Professional | 56 · Pre-op care only | $1.82 | $2.63 | $2.63 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $12.59 Median $15.14 Typical High $15.14 | Professional | GL · Free upgrade | $12.59 | $15.14 | $15.14 |
Where New York sits
The same service costs 4.1 times more in Wyoming 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· 46th of 51
$23.44
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.