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 $707.95 Median $707.95 Typical High $707.95 | Facility | None | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,000.00 | Professional | None | $707.95 | $707.95 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $912.01 | Facility | None | $138.04 | $165.96 | $912.01 |
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 $1,621.81 | Facility | None | $151.36 | $537.03 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $1,348.96 Typical High $1,348.96 | Professional | None | $263.03 | $1,348.96 | $1,348.96 |
Excellus BCBS Setting Facility Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Facility | None | $977.24 | $1,000.00 | $1,000.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,000.00 | Professional | None | $977.24 | $977.24 | $1,000.00 |
MVP Health Care Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $2,884.03 | Facility | None | $1,202.26 | $1,202.26 | $2,884.03 |
MVP Health Care Setting Professional Modifier None Typical Low $1,023.29 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,621.81 | $1,621.81 |
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 $977.24 Median $1,000.00 Typical High $1,000.00 | Facility | None | $977.24 | $1,000.00 | $1,000.00 |
Univera Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,000.00 | Professional | None | $977.24 | $977.24 | $1,000.00 |
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 $354.81 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $70.79 |
Where New York sits
The same service costs 13.2 times more in Hawaii 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
$708
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.