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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $177.83 | Professional | None | $102.33 | $102.33 | $177.83 |
CDPHP Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
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 $151.36 Median $229.09 Typical High $501.19 | Facility | None | $151.36 | $229.09 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $229.09 | Professional | None | $162.18 | $229.09 | $229.09 |
Excellus BCBS Setting Facility Modifier None Typical Low $229.09 Median $239.88 Typical High $239.88 | Facility | None | $229.09 | $239.88 | $239.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | None | $229.09 | $239.88 | $239.88 |
MVP Health Care Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $489.78 | Facility | None | $128.82 | $128.82 | $489.78 |
MVP Health Care Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $138.04 | Professional | None | $107.15 | $138.04 | $138.04 |
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 $229.09 Median $239.88 Typical High $239.88 | Facility | None | $229.09 | $239.88 | $239.88 |
Univera Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | None | $229.09 | $239.88 | $239.88 |
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 $51.29 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.23 |
Where New York sits
The same service costs 2.4 times more in Wyoming 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· 32nd 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.