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 $4.07 Median $5.75 Typical High $7.41 | Facility | None | $4.07 | $5.75 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $7.41 | Professional | None | $5.75 | $5.75 | $7.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $22.39 | Facility | None | $11.22 | $11.22 | $22.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.95 Median $3.63 Typical High $7.41 | Professional | None | $2.95 | $3.63 | $7.41 |
CDPHP Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
Cigna Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Facility | None | $15.49 | $15.49 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $54.95 | Professional | None | $5.13 | $5.13 | $54.95 |
Emblem Health Setting Facility Modifier None Typical Low $11.48 Median $19.05 Typical High $41.69 | Facility | None | $11.48 | $19.05 | $41.69 |
Emblem Health Setting Professional Modifier None Typical Low $11.48 Median $13.80 Typical High $31.62 | Professional | None | $11.48 | $13.80 | $31.62 |
Excellus BCBS Setting Facility Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Facility | None | $6.46 | $6.46 | $6.46 |
Excellus BCBS Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.92 | Professional | None | $6.46 | $6.46 | $6.92 |
MVP Health Care Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
MVP Health Care Setting Professional Modifier None Typical Low $6.92 Median $11.22 Typical High $19.05 | Professional | None | $6.92 | $11.22 | $19.05 |
United Setting Professional Modifier None Typical Low $5.62 Median $10.72 Typical High $17.38 | Professional | None | $5.62 | $10.72 | $17.38 |
Univera Setting Facility Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Facility | None | $6.46 | $6.46 | $6.46 |
Univera Setting Professional Modifier None Typical Low $5.75 Median $6.46 Typical High $6.92 | Professional | None | $5.75 | $6.46 | $6.92 |
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 $0.85 Median $0.85 Typical High $1.12 | Professional | 55 · Aftercare only | $0.85 | $0.85 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.58 Median $0.58 Typical High $0.76 | Professional | 56 · Pre-op care only | $0.58 | $0.58 | $0.76 |
Where New York sits
The same service costs 4.7 times more in Florida 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
$3.80
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.