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 $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $1,122.02 | Professional | None | $79.43 | $79.43 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $173.78 Typical High $263.03 | Facility | None | $138.04 | $173.78 | $263.03 |
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 $501.19 Typical High $691.83 | Facility | None | $151.36 | $501.19 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $446.68 Typical High $501.19 | Professional | None | $229.09 | $446.68 | $501.19 |
Excellus BCBS Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
MVP Health Care Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $1,071.52 | Facility | None | $102.33 | $102.33 | $1,071.52 |
MVP Health Care Setting Professional Modifier None Typical Low $85.11 Median $794.33 Typical High $794.33 | Professional | None | $85.11 | $794.33 | $794.33 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Univera Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Univera Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
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 $39.81 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $7.94 |
Where New York sits
The same service costs 7.2 times more in Hawaii than in Kentucky. 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· 29th of 51
$126
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.