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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $165.96 Typical High $186.21 | Facility | None | $69.18 | $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 $131.83 Median $158.49 Typical High $501.19 | Facility | None | $131.83 | $158.49 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $112.20 Median $131.83 Typical High $151.36 | Professional | None | $112.20 | $131.83 | $151.36 |
Excellus BCBS Setting Facility Modifier None Typical Low $131.83 Median $165.96 Typical High $165.96 | Facility | None | $131.83 | $165.96 | $165.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $165.96 | Professional | None | $131.83 | $165.96 | $165.96 |
MVP Health Care Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $295.12 | Facility | None | $87.10 | $87.10 | $295.12 |
MVP Health Care Setting Professional Modifier None Typical Low $69.18 Median $83.18 Typical High $83.18 | Professional | None | $69.18 | $83.18 | $83.18 |
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 $131.83 Median $165.96 Typical High $165.96 | Facility | None | $131.83 | $165.96 | $165.96 |
Univera Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $165.96 | Professional | None | $131.83 | $165.96 | $165.96 |
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 $45.71 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $45.71 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.12 |
Where New York sits
The same service costs 2.1 times more in Alaska than in Montana. 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· 5th of 51
$132
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.