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 $147.91 Median $208.93 Typical High $269.15 | Facility | None | $147.91 | $208.93 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $269.15 | Professional | None | $208.93 | $208.93 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $812.83 | Facility | None | $407.38 | $407.38 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $269.15 | Professional | None | $107.15 | $131.83 | $269.15 |
CDPHP Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $1,995.26 | Professional | None | $169.82 | $169.82 | $1,995.26 |
Emblem Health Setting Facility Modifier None Typical Low $416.87 Median $676.08 Typical High $1,479.11 | Facility | None | $416.87 | $676.08 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $1,148.15 | Professional | None | $416.87 | $501.19 | $1,148.15 |
Excellus BCBS Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $190.55 | Facility | None | $158.49 | $158.49 | $190.55 |
Excellus BCBS Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $251.19 | Professional | None | $158.49 | $234.42 | $251.19 |
MVP Health Care Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
MVP Health Care Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $691.83 | Professional | None | $251.19 | $407.38 | $691.83 |
United Setting Professional Modifier None Typical Low $173.78 Median $371.54 Typical High $575.44 | Professional | None | $173.78 | $371.54 | $575.44 |
Univera Setting Facility Modifier None Typical Low $158.49 Median $234.42 Typical High $234.42 | Facility | None | $158.49 | $234.42 | $234.42 |
Univera Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $251.19 | Professional | None | $158.49 | $234.42 | $251.19 |
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 $31.62 Median $31.62 Typical High $40.74 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $26.92 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $26.92 |
Where New York sits
The same service costs 3.2 times more in Iowa than in New York. 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· 51st of 51
$141
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.