How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $58.88 Median $100.00 Typical High $100.00 | Facility | None | $58.88 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $100.00 Typical High $100.00 | Professional | None | $58.88 | $100.00 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $97.72 | Professional | None | $75.86 | $87.10 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Excellus BCBS Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $162.18 | Professional | None | $87.10 | $95.50 | $162.18 |
United Setting Facility Modifier None Typical Low $691.83 Median $812.83 Typical High $1,000.00 | Facility | None | $691.83 | $812.83 | $1,000.00 |
United Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $147.91 | Professional | None | $67.61 | $83.18 | $147.91 |
Univera Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Univera Setting Professional Modifier None Typical Low $52.48 Median $95.50 Typical High $125.89 | Professional | None | $52.48 | $95.50 | $125.89 |
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 $29.51 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $29.51 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $11.75 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $8.71 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.89 | $10.00 | $10.00 |
Where New York sits
The same service costs 5.0 times more in Alaska than in Pennsylvania. 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· 42nd of 51
$87.10
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.