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 $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $851.14 | Professional | None | $549.54 | $549.54 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $186.21 Typical High $295.12 | Facility | None | $138.04 | $186.21 | $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 $1,288.25 | Facility | None | $151.36 | $537.03 | $1,288.25 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $1,071.52 Typical High $1,071.52 | Professional | None | $263.03 | $1,071.52 | $1,071.52 |
Excellus BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,071.52 | $1,318.26 | $1,318.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,071.52 | $1,318.26 |
MVP Health Care Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $2,290.87 | Facility | None | $251.19 | $251.19 | $2,290.87 |
MVP Health Care Setting Professional Modifier None Typical Low $257.04 Median $691.83 Typical High $691.83 | Professional | None | $257.04 | $691.83 | $691.83 |
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 $1,071.52 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,071.52 | $1,318.26 | $1,318.26 |
Univera Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,071.52 | $1,318.26 |
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 $275.42 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $54.95 |
Where New York sits
The same service costs 9.1 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· 14th of 51
$550
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.