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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $512.86 | Professional | None | $123.03 | $123.03 | $512.86 |
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 $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 $251.19 Typical High $251.19 | Professional | None | $239.88 | $251.19 | $251.19 |
MVP Health Care Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $489.78 | Facility | None | $162.18 | $162.18 | $489.78 |
MVP Health Care Setting Professional Modifier None Typical Low $128.82 Median $134.90 Typical High $239.88 | Professional | None | $128.82 | $134.90 | $239.88 |
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 $251.19 Typical High $251.19 | Professional | None | $239.88 | $251.19 | $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 $61.66 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.30 |
Where New York sits
The same service costs 1.9 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· 39th 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.