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 $125.89 Median $151.36 Typical High $181.97 | Facility | None | $125.89 | $151.36 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $316.23 | Professional | None | $151.36 | $151.36 | $316.23 |
CDPHP 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 $138.04 Median $165.96 Typical High $186.21 | Facility | None | $138.04 | $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 $151.36 Median $338.84 Typical High $549.54 | Facility | None | $151.36 | $338.84 | $549.54 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $338.84 | Professional | None | $229.09 | $338.84 | $338.84 |
Excellus BCBS Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $354.81 | Facility | None | $338.84 | $354.81 | $354.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | None | $338.84 | $354.81 | $354.81 |
MVP Health Care Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $724.44 | Facility | None | $190.55 | $190.55 | $724.44 |
MVP Health Care Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | None | $162.18 | $199.53 | $199.53 |
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 $338.84 Median $354.81 Typical High $354.81 | Facility | None | $338.84 | $354.81 | $354.81 |
Univera Setting Professional Modifier None Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | None | $338.84 | $354.81 | $354.81 |
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 $75.86 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.14 |
Where New York sits
The same service costs 2.9 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· 14th of 51
$151
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.