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 $2,511.89 Median $2,951.21 Typical High $3,162.28 | Facility | None | $2,511.89 | $2,951.21 | $3,162.28 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,951.21 | Professional | None | $2,511.89 | $2,511.89 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $741.31 | Professional | None | $524.81 | $524.81 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $645.65 | Facility | None | $138.04 | $165.96 | $645.65 |
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 $3,715.35 | Facility | None | $151.36 | $537.03 | $3,715.35 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $3,162.28 Typical High $3,162.28 | Professional | None | $263.03 | $3,162.28 | $3,162.28 |
Excellus BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,162.28 | $3,388.44 | $3,388.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,388.44 | Professional | None | $3,162.28 | $3,162.28 | $3,388.44 |
MVP Health Care Setting Facility Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Facility | None | $6,760.83 | $6,760.83 | $6,760.83 |
MVP Health Care Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | None | $524.81 | $575.44 | $575.44 |
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 $3,162.28 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,162.28 | $3,388.44 | $3,388.44 |
Univera Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,388.44 | Professional | None | $3,162.28 | $3,162.28 | $3,388.44 |
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 $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $588.84 | Professional | 53 · Discontinued | $512.86 | $512.86 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $295.12 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $295.12 |
Where New York sits
The same service costs 26.9 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
$525
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.