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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $371.54 | Professional | None | $346.74 | $346.74 | $371.54 |
CDPHP Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $186.21 Typical High $223.87 | Facility | None | $138.04 | $186.21 | $223.87 |
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 $229.09 Median $977.24 Typical High $977.24 | Professional | None | $229.09 | $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 $1,000.00 Typical High $1,000.00 | Professional | None | $977.24 | $1,000.00 | $1,000.00 |
MVP Health Care Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $1,479.11 | Facility | None | $457.09 | $457.09 | $1,479.11 |
MVP Health Care Setting Professional Modifier None Typical Low $380.19 Median $436.52 Typical High $436.52 | Professional | None | $380.19 | $436.52 | $436.52 |
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 $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 $1,000.00 Typical High $1,000.00 | Professional | None | $977.24 | $1,000.00 | $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 $173.78 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $34.67 |
Where New York sits
The same service costs 5.9 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· 12th of 51
$347
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.