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 $32.36 Median $38.02 Typical High $39.81 | Facility | None | $32.36 | $38.02 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | None | $32.36 | $32.36 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $44.67 Typical High $109.65 | Professional | None | $43.65 | $44.67 | $109.65 |
CDPHP Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $165.96 Typical High $186.21 | Facility | None | $42.66 | $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 $6.17 Median $138.04 Typical High $501.19 | Facility | None | $6.17 | $138.04 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $5.25 Median $6.17 Typical High $6.61 | Professional | None | $5.25 | $6.17 | $6.61 |
Excellus BCBS Setting Facility Modifier None Typical Low $6.17 Median $6.46 Typical High $6.46 | Facility | None | $6.17 | $6.46 | $6.46 |
Excellus BCBS Setting Professional Modifier None Typical Low $6.17 Median $6.46 Typical High $6.46 | Professional | None | $6.17 | $6.46 | $6.46 |
MVP Health Care Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
United Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $165.96 | Professional | None | $120.23 | $125.89 | $165.96 |
Univera Setting Facility Modifier None Typical Low $6.17 Median $6.46 Typical High $6.46 | Facility | None | $6.17 | $6.46 | $6.46 |
Univera Setting Professional Modifier None Typical Low $6.17 Median $6.46 Typical High $6.46 | Professional | None | $6.17 | $6.46 | $6.46 |
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 $16.22 Median $16.22 Typical High $19.05 | Professional | 52 · Reduced service | $16.22 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | 53 · Discontinued | $6.46 | $6.46 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.62 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.80 |
Where New York sits
The same service costs 4.8 times more in North Dakota than in Hawaii. 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· 44th of 51
$44.67
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.