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 $26.30 Median $30.90 Typical High $32.36 | Facility | None | $26.30 | $30.90 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $30.90 | Professional | None | $26.30 | $26.30 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $89.13 | Professional | None | $26.92 | $26.92 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $36.31 Typical High $57.54 | Facility | None | $32.36 | $36.31 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $173.78 | Professional | None | $32.36 | $32.36 | $173.78 |
Emblem Health Setting Facility Modifier None Typical Low $25.12 Median $33.88 Typical High $85.11 | Facility | None | $25.12 | $33.88 | $85.11 |
Emblem Health Setting Professional Modifier None Typical Low $27.54 Median $32.36 Typical High $32.36 | Professional | None | $27.54 | $32.36 | $32.36 |
Excellus BCBS Setting Facility Modifier None Typical Low $32.36 Median $33.88 Typical High $33.88 | Facility | None | $32.36 | $33.88 | $33.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | None | $32.36 | $33.88 | $33.88 |
MVP Health Care Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $70.79 | Facility | None | $34.67 | $34.67 | $70.79 |
MVP Health Care Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
United Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $44.67 | Professional | None | $32.36 | $33.88 | $44.67 |
Univera Setting Facility Modifier None Typical Low $32.36 Median $33.88 Typical High $33.88 | Facility | None | $32.36 | $33.88 | $33.88 |
Univera Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | None | $32.36 | $33.88 | $33.88 |
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 $13.18 Median $13.18 Typical High $15.49 | Professional | 52 · Reduced service | $13.18 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $6.17 | Professional | 53 · Discontinued | $5.25 | $5.25 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $4.57 | Professional | 55 · Aftercare only | $3.98 | $3.98 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.63 | $2.63 | $3.09 |
Where New York sits
The same service costs 1.9 times more in Alaska than in Connecticut. 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· 28th of 51
$32.36
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.