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 $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $29.51 Median $33.88 Typical High $37.15 | Professional | None | $29.51 | $33.88 | $37.15 |
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 $33.88 Median $138.04 Typical High $501.19 | Facility | None | $33.88 | $138.04 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $158.49 | Professional | None | $33.88 | $33.88 | $158.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $169.82 | Professional | None | $120.23 | $125.89 | $169.82 |
MVP Health Care Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
MVP Health Care Setting Professional Modifier None Typical Low $30.20 Median $42.66 Typical High $42.66 | Professional | None | $30.20 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $165.96 | Professional | None | $125.89 | $125.89 | $165.96 |
Univera Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $169.82 | Professional | None | $120.23 | $125.89 | $169.82 |
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 $16.98 Median $16.98 Typical High $16.98 | Professional | 52 · Reduced service | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 53 · Discontinued | $6.76 | $6.76 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $3.39 |
Where New York sits
The same service costs 4.2 times more in North Dakota than in Maryland. 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· 47th of 51
$33.88
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.