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 $26.92 Median $30.90 Typical High $33.11 | Facility | None | $26.92 | $30.90 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $30.90 | Professional | None | $26.92 | $26.92 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $61.66 | Professional | None | $10.00 | $10.00 | $61.66 |
CDPHP Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $37.15 Typical High $57.54 | Facility | None | $33.11 | $37.15 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Emblem Health Setting Facility Modifier None Typical Low $9.55 Median $33.11 Typical High $42.66 | Facility | None | $9.55 | $33.11 | $42.66 |
Emblem Health Setting Professional Modifier None Typical Low $16.60 Median $33.11 Typical High $33.11 | Professional | None | $16.60 | $33.11 | $33.11 |
Excellus BCBS Setting Facility Modifier None Typical Low $33.11 Median $41.69 Typical High $41.69 | Facility | None | $33.11 | $41.69 | $41.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $33.11 Median $41.69 Typical High $41.69 | Professional | None | $33.11 | $41.69 | $41.69 |
MVP Health Care Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $70.79 | Facility | None | $13.49 | $13.49 | $70.79 |
MVP Health Care Setting Professional Modifier None Typical Low $12.59 Median $15.14 Typical High $15.14 | Professional | None | $12.59 | $15.14 | $15.14 |
United Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $51.29 | Professional | None | $38.90 | $38.90 | $51.29 |
Univera Setting Facility Modifier None Typical Low $33.11 Median $41.69 Typical High $41.69 | Facility | None | $33.11 | $41.69 | $41.69 |
Univera Setting Professional Modifier None Typical Low $33.11 Median $41.69 Typical High $41.69 | Professional | None | $33.11 | $41.69 | $41.69 |
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 $13.49 Median $13.49 Typical High $15.49 | Professional | 52 · Reduced service | $13.49 | $13.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.37 Median $5.37 Typical High $6.31 | Professional | 53 · Discontinued | $5.37 | $5.37 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $4.68 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $3.09 |
Where New York sits
The same service costs 5.6 times more in Alaska 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· 26th of 51
$33.11
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.