How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $30.90 Median $42.66 Typical High $54.95 | Facility | None | $30.90 | $42.66 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $54.95 | Professional | None | $42.66 | $42.66 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $165.96 | Facility | None | $83.18 | $83.18 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.88 Median $26.92 Typical High $54.95 | Professional | None | $21.88 | $26.92 | $54.95 |
CDPHP Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $407.38 | Professional | None | $0.09 | $0.09 | $407.38 |
Emblem Health Setting Facility Modifier None Typical Low $85.11 Median $141.25 Typical High $309.03 | Facility | None | $85.11 | $141.25 | $309.03 |
Emblem Health Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $234.42 | Professional | None | $85.11 | $102.33 | $234.42 |
Excellus BCBS Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Excellus BCBS Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $51.29 | Professional | None | $47.86 | $47.86 | $51.29 |
MVP Health Care Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
MVP Health Care Setting Professional Modifier None Typical Low $51.29 Median $83.18 Typical High $144.54 | Professional | None | $51.29 | $83.18 | $144.54 |
United Setting Professional Modifier None Typical Low $41.69 Median $75.86 Typical High $117.49 | Professional | None | $41.69 | $75.86 | $117.49 |
Univera Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Univera Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $51.29 | Professional | None | $47.86 | $47.86 | $51.29 |
2 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 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $8.32 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $5.62 |
Where New York sits
The same service costs 5.5 times more in Iowa than in Kansas. 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
$28.18
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.