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 $30.90 Median $37.15 Typical High $91.20 | Facility | None | $30.90 | $37.15 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $35.48 | Professional | None | $30.90 | $30.90 | $35.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.84 | Facility | None | $28.18 | $28.18 | $28.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
CDPHP Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $39.81 Typical High $53.70 | Facility | None | $33.11 | $39.81 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $120.23 | Professional | None | $30.90 | $30.90 | $120.23 |
Emblem Health Setting Facility Modifier None Typical Low $28.84 Median $36.31 Typical High $97.72 | Facility | None | $28.84 | $36.31 | $97.72 |
Emblem Health Setting Professional Modifier None Typical Low $26.92 Median $31.62 Typical High $36.31 | Professional | None | $26.92 | $31.62 | $36.31 |
Excellus BCBS Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $60.26 | Facility | None | $22.91 | $22.91 | $60.26 |
MVP Health Care Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $109.65 | Facility | None | $26.92 | $26.92 | $109.65 |
MVP Health Care Setting Professional Modifier None Typical Low $19.95 Median $26.92 Typical High $37.15 | Professional | None | $19.95 | $26.92 | $37.15 |
United Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Univera Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $38.90 | Facility | None | $37.15 | $37.15 | $38.90 |
Univera Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $44.67 | Professional | None | $37.15 | $37.15 | $44.67 |
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 $15.49 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
Where New York sits
The same service costs 1.9 times more in Texas than in Tennessee. 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
$31.62
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.