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 $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $218.78 | Professional | None | $81.28 | $97.72 | $218.78 |
CDPHP Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $186.21 Typical High $363.08 | Facility | None | $134.90 | $186.21 | $363.08 |
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 $194.98 Typical High $501.19 | Facility | None | $151.36 | $194.98 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $173.78 | Professional | None | $147.91 | $173.78 | $173.78 |
Excellus BCBS Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
MVP Health Care Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $380.19 | Facility | None | $138.04 | $138.04 | $380.19 |
MVP Health Care Setting Professional Modifier None Typical Low $102.33 Median $107.15 Typical High $117.49 | Professional | None | $102.33 | $107.15 | $117.49 |
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 $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Univera Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
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 $48.98 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $9.77 |
Where New York sits
The same service costs 2.0 times more in Alaska 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· 28th 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.