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 $269.15 Typical High $602.56 | Facility | None | $208.93 | $269.15 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $213.80 | Facility | None | $208.93 | $208.93 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $323.59 | Professional | None | $208.93 | $208.93 | $323.59 |
CDPHP Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $275.42 Typical High $316.23 | Facility | None | $186.21 | $275.42 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $870.96 | Professional | None | $208.93 | $208.93 | $870.96 |
Emblem Health Setting Facility Modifier None Typical Low $199.53 Median $239.88 Typical High $446.68 | Facility | None | $199.53 | $239.88 | $446.68 |
Emblem Health Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $257.04 | Professional | None | $218.78 | $218.78 | $257.04 |
Excellus BCBS Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $213.80 | Facility | None | $208.93 | $208.93 | $213.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $213.80 | Professional | None | $208.93 | $208.93 | $213.80 |
MVP Health Care Setting Facility Modifier None Typical Low $229.09 Median $263.03 Typical High $436.52 | Facility | None | $229.09 | $263.03 | $436.52 |
MVP Health Care Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $257.04 | Professional | None | $186.21 | $257.04 | $257.04 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $281.84 | Professional | None | $199.53 | $218.78 | $281.84 |
Univera Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $218.78 | Facility | None | $208.93 | $208.93 | $218.78 |
Univera Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $213.80 | Professional | None | $162.18 | $208.93 | $213.80 |
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 $104.71 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | 53 · Discontinued | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $20.89 |
Where New York sits
The same service costs 1.6 times more in Arizona than in New Jersey. 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· 31st of 51
$209
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.