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 $39.81 Median $45.71 Typical High $48.98 | Facility | None | $39.81 | $45.71 | $48.98 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $45.71 | Professional | None | $39.81 | $39.81 | $45.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $147.91 Typical High $147.91 | Professional | None | $52.48 | $147.91 | $147.91 |
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 $151.36 Median $537.03 Typical High $1,621.81 | Facility | None | $151.36 | $537.03 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $1,348.96 Typical High $1,348.96 | Professional | None | $162.18 | $1,348.96 | $1,348.96 |
Excellus BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,348.96 | $1,659.59 | $1,659.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,348.96 | $1,659.59 |
MVP Health Care Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $186.21 | Professional | None | $147.91 | $186.21 | $186.21 |
United Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $169.82 | Professional | None | $120.23 | $125.89 | $169.82 |
Univera Setting Facility Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,348.96 | $1,659.59 | $1,659.59 |
Univera Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,348.96 | $1,659.59 |
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 $19.50 Median $19.50 Typical High $22.91 | Professional | 52 · Reduced service | $19.50 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $9.12 | Professional | 53 · Discontinued | $7.94 | $7.94 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $6.92 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.57 |
Where New York sits
The same service costs 5.1 times more in North Dakota than in New Jersey. 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· 10th of 51
$135
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.