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 $331.13 Median $426.58 Typical High $954.99 | Facility | None | $331.13 | $426.58 | $954.99 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $338.84 | Facility | None | $331.13 | $331.13 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
CDPHP Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $446.68 Typical High $501.19 | Facility | None | $371.54 | $446.68 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $1,380.38 | Professional | None | $338.84 | $338.84 | $1,380.38 |
Emblem Health Setting Facility Modifier None Typical Low $316.23 Median $380.19 Typical High $1,148.15 | Facility | None | $316.23 | $380.19 | $1,148.15 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $416.87 | Professional | None | $338.84 | $338.84 | $416.87 |
Excellus BCBS Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $338.84 | Facility | None | $331.13 | $331.13 | $338.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $338.84 | Professional | None | $331.13 | $331.13 | $338.84 |
MVP Health Care Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $691.83 | Facility | None | $416.87 | $416.87 | $691.83 |
MVP Health Care Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $467.74 | Professional | None | $316.23 | $407.38 | $467.74 |
United Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
United Setting Professional Modifier None Typical Low $331.13 Median $346.74 Typical High $457.09 | Professional | None | $331.13 | $346.74 | $457.09 |
Univera Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $346.74 | Facility | None | $331.13 | $331.13 | $346.74 |
Univera Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $338.84 | Professional | None | $331.13 | $331.13 | $338.84 |
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 $169.82 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Where New York sits
The same service costs 1.5 times more in Arizona than in Rhode Island. 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· 37th of 51
$339
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.