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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $457.09 Typical High $457.09 | Professional | None | $169.82 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $295.12 | Facility | None | $138.04 | $165.96 | $295.12 |
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 $1,698.24 | Facility | None | $151.36 | $537.03 | $1,698.24 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $1,412.54 Typical High $1,412.54 | Professional | None | $263.03 | $1,412.54 | $1,412.54 |
Excellus BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,412.54 | $1,778.28 | $1,778.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,778.28 | $1,778.28 |
MVP Health Care Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $3,019.95 | Facility | None | $426.58 | $426.58 | $3,019.95 |
MVP Health Care Setting Professional Modifier None Typical Low $354.81 Median $1,202.26 Typical High $1,202.26 | Professional | None | $354.81 | $1,202.26 | $1,202.26 |
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 $1,412.54 Median $1,778.28 Typical High $1,778.28 | Facility | None | $1,412.54 | $1,778.28 | $1,778.28 |
Univera Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,778.28 | $1,778.28 |
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 $229.09 Median $229.09 Typical High $229.09 | Professional | 52 · Reduced service | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $45.71 |
Where New York sits
The same service costs 12.0 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· 15th of 51
$457
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.