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 $20.89 Median $38.02 Typical High $87.10 | Facility | None | $20.89 | $38.02 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $30.90 | Facility | None | $29.51 | $29.51 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
CDPHP Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $30.20 Typical High $85.11 | Facility | None | $22.91 | $30.20 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Emblem Health Setting Facility Modifier None Typical Low $19.50 Median $23.44 Typical High $66.07 | Facility | None | $19.50 | $23.44 | $66.07 |
Emblem Health Setting Professional Modifier None Typical Low $16.60 Median $19.50 Typical High $19.50 | Professional | None | $16.60 | $19.50 | $19.50 |
Excellus BCBS Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Excellus BCBS Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
MVP Health Care Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $194.98 | Facility | None | $28.18 | $28.18 | $194.98 |
MVP Health Care Setting Professional Modifier None Typical Low $30.20 Median $43.65 Typical High $43.65 | Professional | None | $30.20 | $43.65 | $43.65 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $29.51 Median $31.62 Typical High $39.81 | Professional | None | $29.51 | $31.62 | $39.81 |
Univera Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $31.62 | Facility | None | $29.51 | $29.51 | $31.62 |
Univera Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
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 $10.47 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | 53 · Discontinued | $4.17 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $2.09 |
Where New York sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 40th of 51
$20.89
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.