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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $89.13 Typical High $120.23 | Professional | None | $77.62 | $89.13 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $190.55 | Facility | None | $138.04 | $165.96 | $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 $537.03 Typical High $1,698.24 | Facility | None | $151.36 | $537.03 | $1,698.24 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $1,412.54 Typical High $1,412.54 | Professional | None | $218.78 | $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 $1,412.54 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,412.54 | $1,778.28 |
MVP Health Care Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $3,019.95 | Facility | None | $104.71 | $104.71 | $3,019.95 |
MVP Health Care Setting Professional Modifier None Typical Low $75.86 Median $85.11 Typical High $85.11 | Professional | None | $75.86 | $85.11 | $85.11 |
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 $1,412.54 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,412.54 | $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 $44.67 Median $44.67 Typical High $44.67 | Professional | 52 · Reduced service | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 53 · Discontinued | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $8.91 |
Where New York sits
The same service costs 17.4 times more in Wyoming than in Montana. 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· 18th 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.