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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $186.21 Typical High $363.08 | Facility | None | $138.04 | $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 $85.11 Median $144.54 Typical High $501.19 | Facility | None | $85.11 | $144.54 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $138.04 | Professional | None | $72.44 | $85.11 | $138.04 |
Excellus BCBS Setting Facility Modifier None Typical Low $85.11 Median $107.15 Typical High $107.15 | Facility | None | $85.11 | $107.15 | $107.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $107.15 | Professional | None | $85.11 | $107.15 | $107.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
MVP Health Care Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $380.19 | Facility | None | $85.11 | $85.11 | $380.19 |
MVP Health Care Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $125.89 | Professional | None | $67.61 | $75.86 | $125.89 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Univera Setting Facility Modifier None Typical Low $85.11 Median $107.15 Typical High $107.15 | Facility | None | $85.11 | $107.15 | $107.15 |
Univera Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $107.15 | Professional | None | $85.11 | $107.15 | $107.15 |
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 $33.88 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $6.76 |
Where New York sits
The same service costs 2.6 times more in Wyoming than in Washington, DC. 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· 20th 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.