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 $30.90 Median $36.31 Typical High $39.81 | Facility | None | $30.90 | $36.31 | $39.81 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $36.31 Typical High $36.31 | Professional | None | $30.90 | $36.31 | $36.31 |
Ambetter Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $30.90 Typical High $35.48 | Professional | None | $25.70 | $30.90 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Excellus BCBS Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Optum Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $35.48 | Professional | None | $30.90 | $30.90 | $35.48 |
United Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $35.48 | Professional | None | $30.90 | $30.90 | $35.48 |
Univera Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Univera Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
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 $15.49 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $15.49 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $6.17 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $4.57 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.09 | $3.63 | $3.63 |
Where New York sits
The same service costs 3.1 times more in Montana than in Mississippi. 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· 32nd of 51
$31.62
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.