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 $229.09 Median $295.12 Typical High $660.69 | Facility | None | $229.09 | $295.12 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $234.42 | Facility | None | $229.09 | $229.09 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $323.59 | Professional | None | $234.42 | $234.42 | $323.59 |
CDPHP Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $302.00 Typical High $346.74 | Facility | None | $199.53 | $302.00 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $977.24 | Professional | None | $234.42 | $234.42 | $977.24 |
Emblem Health Setting Facility Modifier None Typical Low $218.78 Median $263.03 Typical High $489.78 | Facility | None | $218.78 | $263.03 | $489.78 |
Emblem Health Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $295.12 | Professional | None | $239.88 | $239.88 | $295.12 |
Excellus BCBS Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $234.42 | Facility | None | $229.09 | $229.09 | $234.42 |
Excellus BCBS Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $234.42 | Professional | None | $229.09 | $229.09 | $234.42 |
Highmark BCBS Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
MVP Health Care Setting Facility Modifier None Typical Low $251.19 Median $295.12 Typical High $489.78 | Facility | None | $251.19 | $295.12 | $489.78 |
MVP Health Care Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $281.84 | Professional | None | $190.55 | $281.84 | $281.84 |
United Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
United Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $309.03 | Professional | None | $213.80 | $239.88 | $309.03 |
Univera Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $239.88 | Facility | None | $229.09 | $229.09 | $239.88 |
Univera Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $234.42 | Professional | None | $144.54 | $229.09 | $234.42 |
2 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 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $23.44 |
Where New York sits
The same service costs 1.6 times more in Arizona than in Hawaii. 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· 24th of 51
$234
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.