How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $123.03 Median $151.36 Typical High $190.55 | Facility | None | $123.03 | $151.36 | $190.55 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $151.36 | Professional | None | $123.03 | $123.03 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $61.66 Typical High $70.79 | Professional | None | $53.70 | $61.66 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $263.03 | Professional | None | $181.97 | $181.97 | $263.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $229.09 | Professional | None | $199.53 | $199.53 | $229.09 |
United Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $478.63 | Professional | None | $177.83 | $251.19 | $478.63 |
Univera Setting Facility Modifier None Typical Low $117.49 Median $199.53 Typical High $229.09 | Facility | None | $117.49 | $199.53 | $229.09 |
Univera Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $229.09 | Professional | None | $117.49 | $199.53 | $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 $60.26 Median $60.26 Typical High $75.86 | Professional | 52 · Reduced service | $60.26 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $30.90 | Professional | 53 · Discontinued | $24.55 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $15.14 |
Where New York sits
The same service costs 6.6 times more in Alabama 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
$66.07
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.