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 $204.17 Median $302.00 Typical High $467.74 | Facility | None | $204.17 | $302.00 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $436.52 | Professional | None | $302.00 | $302.00 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $416.87 | Professional | None | $316.23 | $371.54 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Facility | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Emblem Health Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
MVP Health Care Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $954.99 | Professional | None | $467.74 | $549.54 | $954.99 |
United Setting Professional Modifier None Typical Low $204.17 Median $338.84 Typical High $426.58 | Professional | None | $204.17 | $338.84 | $426.58 |
Univera Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Univera Setting Professional Modifier None Typical Low $223.87 Median $380.19 Typical High $380.19 | Professional | None | $223.87 | $380.19 | $380.19 |
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 $151.36 Median $151.36 Typical High $218.78 | Professional | 52 · Reduced service | $151.36 | $151.36 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $60.26 Typical High $89.13 | Professional | 53 · Discontinued | $60.26 | $60.26 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $66.07 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $43.65 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $43.65 |
Where New York sits
The same service costs 17.0 times more in Iowa than in Kentucky. 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· 29th of 51
$355
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.