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 $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $213.80 | Professional | None | $75.86 | $75.86 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $186.21 Typical High $190.55 | Facility | None | $138.04 | $186.21 | $190.55 |
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 $288.40 Typical High $537.03 | Facility | None | $151.36 | $288.40 | $537.03 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $288.40 | Professional | None | $229.09 | $281.84 | $288.40 |
Excellus BCBS Setting Facility Modifier None Typical Low $288.40 Median $323.59 Typical High $323.59 | Facility | None | $288.40 | $323.59 | $323.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $323.59 | Professional | None | $288.40 | $323.59 | $323.59 |
MVP Health Care Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $616.60 | Facility | None | $102.33 | $102.33 | $616.60 |
MVP Health Care Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $123.03 | Professional | None | $85.11 | $123.03 | $123.03 |
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 $288.40 Median $323.59 Typical High $323.59 | Facility | None | $288.40 | $323.59 | $323.59 |
Univera Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $323.59 | Professional | None | $288.40 | $323.59 | $323.59 |
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 $38.02 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Where New York sits
The same service costs 3.8 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.