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 $109.65 Median $141.25 Typical High $173.78 | Facility | None | $109.65 | $141.25 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $144.54 | Professional | None | $109.65 | $109.65 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $208.93 | Professional | None | $151.36 | $177.83 | $208.93 |
CDPHP Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Emblem Health Setting Facility Modifier None Typical Low $173.78 Median $275.42 Typical High $676.08 | Facility | None | $173.78 | $275.42 | $676.08 |
Emblem Health Setting Professional Modifier None Typical Low $190.55 Median $234.42 Typical High $338.84 | Professional | None | $190.55 | $234.42 | $338.84 |
Excellus BCBS Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $81.28 Median $128.82 Typical High $173.78 | Professional | None | $81.28 | $128.82 | $173.78 |
MVP Health Care Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $269.15 | Professional | None | $154.88 | $154.88 | $269.15 |
United Setting Professional Modifier None Typical Low $123.03 Median $181.97 Typical High $416.87 | Professional | None | $123.03 | $181.97 | $416.87 |
Univera Setting Facility Modifier None Typical Low $151.36 Median $158.49 Typical High $173.78 | Facility | None | $151.36 | $158.49 | $173.78 |
Univera Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $173.78 | Professional | None | $81.28 | $151.36 | $173.78 |
4 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 52 · Reduced service Typical Low $53.70 Median $53.70 Typical High $72.44 | Professional | 52 · Reduced service | $53.70 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $28.84 | Professional | 53 · Discontinued | $21.88 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $21.88 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $14.45 |
Where New York sits
The same service costs 2.3 times more in Alaska than in Arizona. 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· 29th of 51
$170
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.