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 $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $223.87 | Professional | None | $138.04 | $138.04 | $223.87 |
CDPHP Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $186.21 Typical High $363.08 | Facility | None | $138.04 | $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 $151.36 Median $239.88 Typical High $501.19 | Facility | None | $151.36 | $239.88 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $239.88 | Professional | None | $162.18 | $239.88 | $239.88 |
Excellus BCBS Setting Facility Modifier None Typical Low $239.88 Median $251.19 Typical High $251.19 | Facility | None | $239.88 | $251.19 | $251.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $251.19 | Professional | None | $239.88 | $239.88 | $251.19 |
MVP Health Care Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $512.86 | Facility | None | $173.78 | $173.78 | $512.86 |
MVP Health Care Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $173.78 | Professional | None | $144.54 | $173.78 | $173.78 |
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 $239.88 Median $251.19 Typical High $251.19 | Facility | None | $239.88 | $251.19 | $251.19 |
Univera Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $251.19 | Professional | None | $239.88 | $239.88 | $251.19 |
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 $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
Where New York sits
The same service costs 2.2 times more in Alaska 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· 30th of 51
$138
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.