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 $131.83 Median $169.82 Typical High $208.93 | Facility | None | $131.83 | $169.82 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $173.78 | Professional | None | $131.83 | $131.83 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $251.19 | Professional | None | $181.97 | $213.80 | $251.19 |
CDPHP Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Emblem Health Setting Facility Modifier None Typical Low $234.42 Median $371.54 Typical High $891.25 | Facility | None | $234.42 | $371.54 | $891.25 |
Emblem Health Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $446.68 | Professional | None | $257.04 | $309.03 | $446.68 |
Excellus BCBS Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Excellus BCBS Setting Professional Modifier None Typical Low $100.00 Median $194.98 Typical High $229.09 | Professional | None | $100.00 | $194.98 | $229.09 |
MVP Health Care Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $363.08 | Professional | None | $186.21 | $186.21 | $363.08 |
United Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $501.19 | Professional | None | $154.88 | $229.09 | $501.19 |
Univera Setting Facility Modifier None Typical Low $194.98 Median $208.93 Typical High $223.87 | Facility | None | $194.98 | $208.93 | $223.87 |
Univera Setting Professional Modifier None Typical Low $100.00 Median $194.98 Typical High $229.09 | Professional | None | $100.00 | $194.98 | $229.09 |
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 $66.07 Median $66.07 Typical High $87.10 | Professional | 52 · Reduced service | $66.07 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $34.67 | Professional | 53 · Discontinued | $26.30 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $26.30 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $17.38 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $17.38 |
Where New York sits
The same service costs 2.2 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· 40th of 51
$204
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.