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 $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $2,754.23 Typical High $2,754.23 | Professional | None | $102.33 | $2,754.23 | $2,754.23 |
CDPHP Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $190.55 Typical High $380.19 | Facility | None | $134.90 | $190.55 | $380.19 |
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 $4,265.80 | Facility | None | $151.36 | $537.03 | $4,265.80 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $3,548.13 Typical High $3,548.13 | Professional | None | $263.03 | $3,548.13 | $3,548.13 |
Excellus BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,548.13 | $3,715.35 | $3,715.35 |
Excellus BCBS Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,715.35 | Professional | None | $3,548.13 | $3,548.13 | $3,715.35 |
MVP Health Care Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $7,762.47 | Facility | None | $676.08 | $676.08 | $7,762.47 |
MVP Health Care Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $123.03 | Professional | None | $97.72 | $123.03 | $123.03 |
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 $3,548.13 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,548.13 | $3,715.35 | $3,715.35 |
Univera Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,715.35 | Professional | None | $3,548.13 | $3,548.13 | $3,715.35 |
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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $275.42 |
Where New York sits
The same service costs 37.2 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· 8th of 51
$2,754
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.