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 $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $134.90 | Professional | None | $38.90 | $38.90 | $134.90 |
CDPHP Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $165.96 Typical High $186.21 | Facility | None | $128.82 | $165.96 | $186.21 |
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 $1,174.90 | Facility | None | $151.36 | $537.03 | $1,174.90 |
Emblem Health Setting Professional Modifier None Typical Low $213.80 Median $977.24 Typical High $977.24 | Professional | None | $213.80 | $977.24 | $977.24 |
Excellus BCBS Setting Facility Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Facility | None | $977.24 | $1,000.00 | $1,000.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,000.00 | Professional | None | $977.24 | $977.24 | $1,000.00 |
MVP Health Care Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $2,089.30 | Facility | None | $53.70 | $53.70 | $2,089.30 |
MVP Health Care Setting Professional Modifier None Typical Low $46.77 Median $165.96 Typical High $467.74 | Professional | None | $46.77 | $165.96 | $467.74 |
United Setting Professional Modifier None Typical Low $123.03 Median $125.89 Typical High $169.82 | Professional | None | $123.03 | $125.89 | $169.82 |
Univera Setting Facility Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Facility | None | $977.24 | $1,000.00 | $1,000.00 |
Univera Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,000.00 | Professional | None | $977.24 | $977.24 | $1,000.00 |
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 $19.50 Median $19.50 Typical High $19.50 | Professional | 52 · Reduced service | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | 55 · Aftercare only | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 56 · Pre-op care only | $3.89 | $3.89 | $3.89 |
Where New York sits
The same service costs 25.1 times more in Wyoming than in Kentucky. 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· 17th 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.