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 $13.80 Median $16.22 Typical High $39.81 | Facility | None | $13.80 | $16.22 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $18.62 | Professional | None | $16.22 | $16.22 | $18.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $14.13 | Facility | None | $13.80 | $13.80 | $14.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
CDPHP Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $12.30 Median $16.22 Typical High $69.18 | Facility | None | $12.30 | $16.22 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $57.54 | Professional | None | $16.22 | $16.22 | $57.54 |
Emblem Health Setting Facility Modifier None Typical Low $11.75 Median $17.38 Typical High $47.86 | Facility | None | $11.75 | $17.38 | $47.86 |
Emblem Health Setting Professional Modifier None Typical Low $10.00 Median $11.75 Typical High $15.14 | Professional | None | $10.00 | $11.75 | $15.14 |
Excellus BCBS Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $15.49 | Facility | None | $13.80 | $13.80 | $15.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $15.49 | Professional | None | $13.80 | $13.80 | $15.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $19.05 Median $21.88 Typical High $85.11 | Facility | None | $19.05 | $21.88 | $85.11 |
MVP Health Care Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $158.49 | Facility | None | $33.88 | $33.88 | $158.49 |
MVP Health Care Setting Professional Modifier None Typical Low $23.44 Median $28.18 Typical High $30.20 | Professional | None | $23.44 | $28.18 | $30.20 |
United Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
United Setting Professional Modifier None Typical Low $13.80 Median $18.20 Typical High $33.11 | Professional | None | $13.80 | $18.20 | $33.11 |
Univera Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $15.49 | Facility | None | $13.80 | $13.80 | $15.49 |
Univera Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $15.49 | Professional | None | $13.80 | $13.80 | $15.49 |
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 $8.13 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.62 |
Where New York sits
The same service costs 5.9 times more in Wyoming than in North Dakota. 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· 45th of 51
$16.22
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.