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 $13.18 Median $18.62 Typical High $23.99 | Facility | None | $13.18 | $18.62 | $23.99 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $23.99 | Professional | None | $18.62 | $18.62 | $23.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $72.44 | Facility | None | $36.31 | $36.31 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.55 Median $11.75 Typical High $23.99 | Professional | None | $9.55 | $11.75 | $23.99 |
CDPHP Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $177.83 | Professional | None | $21.38 | $21.38 | $177.83 |
Emblem Health Setting Facility Modifier None Typical Low $37.15 Median $61.66 Typical High $134.90 | Facility | None | $37.15 | $61.66 | $134.90 |
Emblem Health Setting Professional Modifier None Typical Low $37.15 Median $44.67 Typical High $102.33 | Professional | None | $37.15 | $44.67 | $102.33 |
Excellus BCBS Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $20.89 Median $22.39 Typical High $28.18 | Professional | None | $20.89 | $22.39 | $28.18 |
MVP Health Care Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
MVP Health Care Setting Professional Modifier None Typical Low $22.39 Median $36.31 Typical High $61.66 | Professional | None | $22.39 | $36.31 | $61.66 |
United Setting Professional Modifier None Typical Low $18.20 Median $34.67 Typical High $56.23 | Professional | None | $18.20 | $34.67 | $56.23 |
Univera Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $28.18 | Facility | None | $20.89 | $20.89 | $28.18 |
Univera Setting Professional Modifier None Typical Low $20.89 Median $22.39 Typical High $28.18 | Professional | None | $20.89 | $22.39 | $28.18 |
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 $2.82 Median $2.82 Typical High $3.63 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $2.40 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $2.40 |
Where New York sits
The same service costs 3.5 times more in Montana 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
$12.59
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.