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 $33.88 Median $41.69 Typical High $97.72 | Facility | None | $33.88 | $41.69 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $41.69 | Professional | None | $33.88 | $33.88 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $22.39 Typical High $25.70 | Professional | None | $18.62 | $22.39 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $27.54 Typical High $44.67 | Facility | None | $25.70 | $27.54 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Emblem Health Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $114.82 | Facility | None | $70.79 | $70.79 | $114.82 |
Emblem Health Setting Professional Modifier None Typical Low $63.10 Median $70.79 Typical High $81.28 | Professional | None | $63.10 | $70.79 | $81.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
United Setting Professional Modifier None Typical Low $22.91 Median $70.79 Typical High $81.28 | Professional | None | $22.91 | $70.79 | $81.28 |
Univera Setting Facility Modifier None Typical Low $25.70 Median $26.92 Typical High $26.92 | Facility | None | $25.70 | $26.92 | $26.92 |
Univera Setting Professional Modifier None Typical Low $16.22 Median $26.92 Typical High $26.92 | Professional | None | $16.22 | $26.92 | $26.92 |
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 $16.98 Median $16.98 Typical High $20.89 | Professional | 52 · Reduced service | $16.98 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $6.76 Typical High $8.32 | Professional | 53 · Discontinued | $6.76 | $6.76 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.13 Typical High $6.31 | Professional | 55 · Aftercare only | $5.13 | $5.13 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.39 Typical High $4.17 | Professional | 56 · Pre-op care only | $3.39 | $3.39 | $4.17 |
Where New York sits
The same service costs 3.1 times more in Wisconsin than in New York. 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· 51st of 51
$22.91
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.