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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $363.08 | Facility | None | $134.90 | $186.21 | $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 $51.29 Median $144.54 Typical High $338.84 | Facility | None | $51.29 | $144.54 | $338.84 |
Emblem Health Setting Professional Modifier None Typical Low $43.65 Median $51.29 Typical High $138.04 | Professional | None | $43.65 | $51.29 | $138.04 |
Excellus BCBS Setting Facility Modifier None Typical Low $51.29 Median $52.48 Typical High $52.48 | Facility | None | $51.29 | $52.48 | $52.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $51.29 Median $52.48 Typical High $52.48 | Professional | None | $51.29 | $52.48 | $52.48 |
MVP Health Care Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $109.65 | Facility | None | $87.10 | $87.10 | $109.65 |
MVP Health Care Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $100.00 | Professional | None | $72.44 | $100.00 | $100.00 |
United Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $165.96 | Professional | None | $117.49 | $125.89 | $165.96 |
Univera Setting Facility Modifier None Typical Low $51.29 Median $52.48 Typical High $52.48 | Facility | None | $51.29 | $52.48 | $52.48 |
Univera Setting Professional Modifier None Typical Low $51.29 Median $52.48 Typical High $52.48 | Professional | None | $51.29 | $52.48 | $52.48 |
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 $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $6.92 |
Where New York sits
The same service costs 2.7 times more in North Dakota than in North Carolina. 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
$69.18
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.