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 $37.15 Median $42.66 Typical High $45.71 | Facility | None | $37.15 | $42.66 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $42.66 | Professional | None | $37.15 | $37.15 | $42.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $33.88 Typical High $85.11 | Professional | None | $33.11 | $33.88 | $85.11 |
CDPHP Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
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 $30.90 Median $138.04 Typical High $501.19 | Facility | None | $30.90 | $138.04 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $25.70 Median $30.90 Typical High $35.48 | Professional | None | $25.70 | $30.90 | $35.48 |
Excellus BCBS Setting Facility Modifier None Typical Low $30.90 Median $31.62 Typical High $31.62 | Facility | None | $30.90 | $31.62 | $31.62 |
Excellus BCBS Setting Professional Modifier None Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | None | $30.90 | $31.62 | $31.62 |
MVP Health Care Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
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 $30.90 Median $31.62 Typical High $31.62 | Facility | None | $30.90 | $31.62 | $31.62 |
Univera Setting Professional Modifier None Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | None | $30.90 | $31.62 | $31.62 |
5 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 $18.20 Median $18.20 Typical High $21.38 | Professional | 52 · Reduced service | $18.20 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $7.41 Typical High $8.51 | Professional | 53 · Discontinued | $7.41 | $7.41 | $8.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $27.54 Typical High $31.62 | Professional | 54 · Surgery only | $27.54 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $6.46 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $4.27 |
Where New York sits
The same service costs 6.3 times more in North Dakota than in Hawaii. 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· 50th of 51
$37.15
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.