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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $398.11 | Professional | None | $107.15 | $107.15 | $398.11 |
CDPHP Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $371.54 | Facility | None | $134.90 | $186.21 | $371.54 |
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 $151.36 Median $478.63 Typical High $691.83 | Facility | None | $151.36 | $478.63 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $478.63 Typical High $478.63 | Professional | None | $162.18 | $478.63 | $478.63 |
Excellus BCBS Setting Facility Modifier None Typical Low $478.63 Median $501.19 Typical High $501.19 | Facility | None | $478.63 | $501.19 | $501.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $501.19 | Professional | None | $478.63 | $478.63 | $501.19 |
MVP Health Care Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $1,023.29 | Facility | None | $114.82 | $114.82 | $1,023.29 |
MVP Health Care Setting Professional Modifier None Typical Low $39.81 Median $190.55 Typical High $190.55 | Professional | None | $39.81 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Professional | None | $125.89 | $125.89 | $173.78 |
Univera Setting Facility Modifier None Typical Low $478.63 Median $501.19 Typical High $501.19 | Facility | None | $478.63 | $501.19 | $501.19 |
Univera Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $501.19 | Professional | None | $478.63 | $478.63 | $501.19 |
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 $53.70 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $21.38 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $10.72 |
Where New York sits
The same service costs 6.0 times more in Wyoming than in Montana. 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· 24th of 51
$126
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.