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 $67.61 Median $85.11 Typical High $104.71 | Facility | None | $67.61 | $85.11 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $104.71 | Professional | None | $67.61 | $67.61 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $112.20 | Professional | None | $70.79 | $83.18 | $112.20 |
CDPHP Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $91.20 Typical High $131.83 | Facility | None | $83.18 | $91.20 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Emblem Health Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Highmark BCBS Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Highmark BCBS Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $147.91 | Professional | None | $45.71 | $75.86 | $147.91 |
Univera Setting Facility Modifier None Typical Low $11.48 Median $31.62 Typical High $31.62 | Facility | None | $11.48 | $31.62 | $31.62 |
Univera Setting Professional Modifier None Typical Low $11.48 Median $31.62 Typical High $33.88 | Professional | None | $11.48 | $31.62 | $33.88 |
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 $33.88 Median $33.88 Typical High $52.48 | Professional | 52 · Reduced service | $33.88 | $33.88 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $20.89 | Professional | 53 · Discontinued | $13.49 | $13.49 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $15.49 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $10.47 |
Where New York sits
The same service costs 5.0 times more in Ohio than in Hawaii. 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· 40th of 51
$81.28
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.