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 $83.18 Median $87.10 Typical High $102.33 | Facility | None | $83.18 | $87.10 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | None | $83.18 | $83.18 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $190.55 Typical High $363.08 | Facility | None | $138.04 | $190.55 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Emblem Health Setting Facility Modifier None Typical Low $102.33 Median $154.88 Typical High $416.87 | Facility | None | $102.33 | $154.88 | $416.87 |
Emblem Health Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $117.49 | Professional | None | $87.10 | $102.33 | $117.49 |
Excellus BCBS Setting Facility Modifier None Typical Low $102.33 Median $117.49 Typical High $117.49 | Facility | None | $102.33 | $117.49 | $117.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $117.49 | Professional | None | $102.33 | $117.49 | $117.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
MVP Health Care Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
United Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $165.96 | Professional | None | $120.23 | $125.89 | $165.96 |
Univera Setting Facility Modifier None Typical Low $102.33 Median $117.49 Typical High $117.49 | Facility | None | $102.33 | $117.49 | $117.49 |
Univera Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $117.49 | Professional | None | $102.33 | $117.49 | $117.49 |
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 $41.69 Median $41.69 Typical High $47.86 | Professional | 52 · Reduced service | $41.69 | $41.69 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $19.50 | Professional | 53 · Discontinued | $16.60 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $14.45 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $9.77 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $9.77 |
Where New York sits
The same service costs 4.4 times more in North Dakota 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· 39th of 51
$110
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.