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 $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $239.88 | Professional | None | $70.79 | $70.79 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $218.78 | Facility | None | $138.04 | $165.96 | $218.78 |
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 $257.04 Typical High $524.81 | Facility | None | $151.36 | $257.04 | $524.81 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $257.04 | Professional | None | $218.78 | $257.04 | $257.04 |
Excellus BCBS Setting Facility Modifier None Typical Low $257.04 Median $263.03 Typical High $263.03 | Facility | None | $257.04 | $263.03 | $263.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $263.03 | Professional | None | $257.04 | $257.04 | $263.03 |
MVP Health Care Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $549.54 | Facility | None | $91.20 | $91.20 | $549.54 |
MVP Health Care Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $120.23 | Professional | None | $77.62 | $120.23 | $120.23 |
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 $257.04 Median $263.03 Typical High $263.03 | Facility | None | $257.04 | $263.03 | $263.03 |
Univera Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $263.03 | Professional | None | $257.04 | $257.04 | $263.03 |
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 $35.48 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.08 |
Where New York sits
The same service costs 3.6 times more in Wyoming 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· 27th 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.