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 $120.23 Median $154.88 Typical High $346.74 | Facility | None | $120.23 | $154.88 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $138.04 | Professional | None | $131.83 | $131.83 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $123.03 | Facility | None | $120.23 | $120.23 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $407.38 | Professional | None | $131.83 | $131.83 | $407.38 |
CDPHP Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $169.82 Typical High $295.12 | Facility | None | $141.25 | $169.82 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $512.86 | Professional | None | $131.83 | $131.83 | $512.86 |
Emblem Health Setting Facility Modifier None Typical Low $125.89 Median $154.88 Typical High $416.87 | Facility | None | $125.89 | $154.88 | $416.87 |
Emblem Health Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | None | $112.20 | $134.90 | $134.90 |
Excellus BCBS Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
MVP Health Care Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $724.44 | Facility | None | $35.48 | $35.48 | $724.44 |
MVP Health Care Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $33.11 | Professional | None | $24.55 | $24.55 | $33.11 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $288.40 | Professional | None | $120.23 | $158.49 | $288.40 |
Univera Setting Facility Modifier None Typical Low $120.23 Median $120.23 Typical High $128.82 | Facility | None | $120.23 | $120.23 | $128.82 |
Univera Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | None | $120.23 | $120.23 | $144.54 |
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 $66.07 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $13.18 |
Where New York sits
The same service costs 8.7 times more in Texas than in Kansas. 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· 31st of 51
$132
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.