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 $50.12 Median $61.66 Typical High $144.54 | Facility | None | $50.12 | $61.66 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $57.54 | Professional | None | $50.12 | $50.12 | $57.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $69.18 | Professional | None | $60.26 | $60.26 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $107.15 Typical High $107.15 | Facility | None | $61.66 | $107.15 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Emblem Health Setting Facility Modifier None Typical Low $60.26 Median $95.50 Typical High $173.78 | Facility | None | $60.26 | $95.50 | $173.78 |
Emblem Health Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $102.33 | Professional | None | $60.26 | $60.26 | $102.33 |
Excellus BCBS Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $61.66 | Facility | None | $60.26 | $60.26 | $61.66 |
Excellus BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $61.66 | Professional | None | $60.26 | $60.26 | $61.66 |
MVP Health Care Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
MVP Health Care Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $371.54 | Professional | None | $102.33 | $102.33 | $371.54 |
United Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $64.57 | Professional | None | $56.23 | $60.26 | $64.57 |
Univera Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $70.79 | Facility | None | $60.26 | $60.26 | $70.79 |
Univera Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $61.66 | Professional | None | $60.26 | $60.26 | $61.66 |
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 $25.12 Median $25.12 Typical High $28.84 | Professional | 52 · Reduced service | $25.12 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $11.48 | Professional | 53 · Discontinued | $10.00 | $10.00 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $8.71 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.75 |
Where New York sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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· 42nd of 51
$60.26
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.