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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $1,096.48 | Professional | None | $489.78 | $489.78 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $229.09 | Facility | None | $138.04 | $165.96 | $229.09 |
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 $537.03 Typical High $1,000.00 | Facility | None | $151.36 | $537.03 | $1,000.00 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $831.76 Typical High $831.76 | Professional | None | $263.03 | $831.76 | $831.76 |
Excellus BCBS Setting Facility Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,047.13 | Facility | None | $831.76 | $1,047.13 | $1,047.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,047.13 | Professional | None | $831.76 | $831.76 | $1,047.13 |
MVP Health Care Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $1,778.28 | Facility | None | $630.96 | $630.96 | $1,778.28 |
MVP Health Care Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $912.01 | Professional | None | $346.74 | $524.81 | $912.01 |
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 $831.76 Median $1,047.13 Typical High $1,047.13 | Facility | None | $831.76 | $1,047.13 | $1,047.13 |
Univera Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,047.13 | Professional | None | $831.76 | $831.76 | $1,047.13 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $48.98 | $48.98 | $48.98 |
Where New York sits
The same service costs 7.1 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· 20th of 51
$490
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.