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 $11.48 Median $75.86 Typical High $100.00 | Facility | None | $11.48 | $75.86 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $75.86 Typical High $75.86 | Professional | None | $11.48 | $75.86 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $213.80 | Professional | None | $165.96 | $190.55 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $75.86 Typical High $100.00 | Facility | None | $70.79 | $75.86 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Emblem Health Setting Facility Modifier None Typical Low $16.60 Median $26.92 Typical High $63.10 | Facility | None | $16.60 | $26.92 | $63.10 |
Emblem Health Setting Professional Modifier None Typical Low $18.20 Median $18.62 Typical High $28.84 | Professional | None | $18.20 | $18.62 | $28.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $28.84 | Professional | None | $15.14 | $15.14 | $28.84 |
United Setting Facility Modifier None Typical Low $707.95 Median $2,818.38 Typical High $4,897.79 | Facility | None | $707.95 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $12.30 Median $15.14 Typical High $40.74 | Professional | None | $12.30 | $15.14 | $40.74 |
Univera Setting Facility Modifier None Typical Low $12.88 Median $15.14 Typical High $15.14 | Facility | None | $12.88 | $15.14 | $15.14 |
Univera Setting Professional Modifier None Typical Low $9.12 Median $15.14 Typical High $24.55 | Professional | None | $9.12 | $15.14 | $24.55 |
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 $5.75 Median $37.15 Typical High $37.15 | Professional | 52 · Reduced service | $5.75 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $2.29 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $1.74 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $1.15 | $7.59 | $7.59 |
Where New York sits
The same service costs 19.1 times more in Indiana than in Delaware. 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· 7th of 51
$174
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.