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 $36.31 Median $36.31 Typical High $331.13 | Facility | None | $36.31 | $36.31 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $63.10 Typical High $72.44 | Professional | None | $51.29 | $63.10 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | None | $7.59 | $7.59 | $7.59 |
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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Excellus BCBS Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $44.67 | Professional | None | $42.66 | $44.67 | $44.67 |
Highmark BCBS Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $53.70 | Facility | None | $45.71 | $45.71 | $53.70 |
Univera Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $44.67 | Facility | None | $42.66 | $42.66 | $44.67 |
Univera Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $44.67 | Professional | None | $42.66 | $44.67 | $44.67 |
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 $18.20 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
Where New York sits
The same service costs 204.2 times more in Montana than in Kansas. 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· 2nd of 51
$61.66
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.