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 $4.27 Median $6.03 Typical High $7.76 | Facility | None | $4.27 | $6.03 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $7.76 | Professional | None | $6.03 | $6.03 | $7.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $23.44 | Facility | None | $11.48 | $11.48 | $23.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $3.72 Typical High $7.59 | Professional | None | $3.09 | $3.72 | $7.59 |
CDPHP Setting Professional Modifier None Typical Low $6.92 Median $6.92 Typical High $6.92 | Professional | None | $6.92 | $6.92 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $57.54 | Professional | None | $5.13 | $5.13 | $57.54 |
Emblem Health Setting Facility Modifier None Typical Low $11.75 Median $19.50 Typical High $42.66 | Facility | None | $11.75 | $19.50 | $42.66 |
Emblem Health Setting Professional Modifier None Typical Low $11.75 Median $14.13 Typical High $33.11 | Professional | None | $11.75 | $14.13 | $33.11 |
Excellus BCBS Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
Excellus BCBS Setting Professional Modifier None Typical Low $6.61 Median $7.08 Typical High $9.12 | Professional | None | $6.61 | $7.08 | $9.12 |
MVP Health Care Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
MVP Health Care Setting Professional Modifier None Typical Low $7.24 Median $11.48 Typical High $19.95 | Professional | None | $7.24 | $11.48 | $19.95 |
United Setting Professional Modifier None Typical Low $5.75 Median $10.96 Typical High $18.20 | Professional | None | $5.75 | $10.96 | $18.20 |
Univera Setting Facility Modifier None Typical Low $6.61 Median $6.76 Typical High $9.12 | Facility | None | $6.61 | $6.76 | $9.12 |
Univera Setting Professional Modifier None Typical Low $6.61 Median $7.08 Typical High $9.12 | Professional | None | $6.61 | $7.08 | $9.12 |
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 $0.89 Median $0.89 Typical High $1.15 | Professional | 55 · Aftercare only | $0.89 | $0.89 | $1.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.60 Median $0.60 Typical High $0.78 | Professional | 56 · Pre-op care only | $0.60 | $0.60 | $0.78 |
Where New York sits
The same service costs 4.6 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
$4.07
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.