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 $645.65 Median $812.83 Typical High $1,000.00 | Facility | None | $645.65 | $812.83 | $1,000.00 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | None | $645.65 | $645.65 | $891.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $645.65 Typical High $707.95 | Professional | None | $549.54 | $645.65 | $707.95 |
CDPHP Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,412.54 Typical High $1,412.54 | Facility | None | $912.01 | $1,412.54 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,445.44 | Professional | None | $645.65 | $758.58 | $1,445.44 |
Emblem Health Setting Facility Modifier None Typical Low $426.58 Median $549.54 Typical High $891.25 | Facility | None | $426.58 | $549.54 | $891.25 |
Emblem Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $724.44 | Professional | None | $489.78 | $489.78 | $724.44 |
Excellus BCBS Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $954.99 | Professional | None | $489.78 | $707.95 | $954.99 |
MVP Health Care Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Facility | None | $870.96 | $870.96 | $870.96 |
MVP Health Care Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
United Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $831.76 | Professional | None | $371.54 | $467.74 | $831.76 |
Univera Setting Facility Modifier None Typical Low $354.81 Median $691.83 Typical High $1,513.56 | Facility | None | $354.81 | $691.83 | $1,513.56 |
Univera Setting Professional Modifier None Typical Low $489.78 Median $707.95 Typical High $933.25 | Professional | None | $489.78 | $707.95 | $933.25 |
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 $323.59 Median $323.59 Typical High $436.52 | Professional | 52 · Reduced service | $323.59 | $323.59 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | 53 · Discontinued | $128.82 | $128.82 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $131.83 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $89.13 |
Where New York sits
The same service costs 3.5 times more in Alaska than in Arkansas. 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· 46th of 51
$631
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.