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 $16.60 Median $17.78 Typical High $257.04 | Facility | None | $16.60 | $17.78 | $257.04 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $257.04 | Professional | None | $16.60 | $16.60 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $38.02 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.13 Median $18.62 Typical High $30.90 | Professional | None | $14.13 | $18.62 | $30.90 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
1 more rate 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 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $25.70 |
Where New York sits
The same service costs 57.5 times more in Nebraska 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· 50th of 51
$16.60
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.