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 $123.03 Median $144.54 Typical High $151.36 | Facility | None | $123.03 | $144.54 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | None | $123.03 | $123.03 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $338.84 | Professional | None | $162.18 | $169.82 | $338.84 |
CDPHP Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $162.18 Typical High $229.09 | Facility | None | $151.36 | $162.18 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Excellus BCBS Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $190.55 | Facility | None | $151.36 | $190.55 | $190.55 |
Excellus BCBS Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $190.55 | Professional | None | $151.36 | $190.55 | $190.55 |
MVP Health Care Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $177.83 Median $181.97 Typical High $234.42 | Professional | None | $177.83 | $181.97 | $234.42 |
Univera Setting Facility Modifier None Typical Low $151.36 Median $190.55 Typical High $190.55 | Facility | None | $151.36 | $190.55 | $190.55 |
Univera Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $190.55 | Professional | None | $151.36 | $190.55 | $190.55 |
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 $61.66 Median $61.66 Typical High $72.44 | Professional | 52 · Reduced service | $61.66 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $28.84 | Professional | 53 · Discontinued | $25.12 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $21.38 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $14.45 |
Where New York sits
The same service costs 2.2 times more in North Carolina than in Michigan. 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
$170
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.