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 $208.93 Median $239.88 Typical High $933.25 | Facility | None | $208.93 | $239.88 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $239.88 Typical High $239.88 | Professional | None | $208.93 | $239.88 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $269.15 | Professional | None | $229.09 | $257.04 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $52.48 Typical High $60.26 | Professional | None | $43.65 | $52.48 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | None | $15.49 | $15.49 | $15.49 |
Emblem Health Setting Facility Modifier None Typical Low $0.10 Median $0.10 Typical High $0.10 | Facility | None | $0.10 | $0.10 | $0.10 |
Excellus BCBS Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Highmark BCBS Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Optum Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $234.42 | Professional | None | $208.93 | $208.93 | $234.42 |
United Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Univera Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Univera Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $102.33 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $102.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $41.69 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $30.90 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $20.89 | $23.99 | $23.99 |
Where New York sits
The same service costs 6.3 times more in Alaska 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
$53.70
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.