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 $8.13 Median $8.13 Typical High $14.79 | Facility | None | $8.13 | $8.13 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
CDPHP Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Cigna Setting Facility Modifier None Typical Low $2.29 Median $10.72 Typical High $12.30 | Facility | None | $2.29 | $10.72 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Emblem Health Setting Facility Modifier None Typical Low $7.59 Median $9.12 Typical High $27.54 | Facility | None | $7.59 | $9.12 | $27.54 |
Emblem Health Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.91 | Professional | None | $8.13 | $8.13 | $8.91 |
Excellus BCBS Setting Facility Modifier None Typical Low $7.41 Median $9.77 Typical High $9.77 | Facility | None | $7.41 | $9.77 | $9.77 |
Excellus BCBS Setting Professional Modifier None Typical Low $7.41 Median $9.77 Typical High $9.77 | Professional | None | $7.41 | $9.77 | $9.77 |
Highmark BCBS Setting Facility Modifier None Typical Low $1.86 Median $7.59 Typical High $11.75 | Facility | None | $1.86 | $7.59 | $11.75 |
MVP Health Care Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $21.38 | Facility | None | $6.92 | $6.92 | $21.38 |
MVP Health Care Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
United Setting Professional Modifier None Typical Low $6.46 Median $7.24 Typical High $7.59 | Professional | None | $6.46 | $7.24 | $7.59 |
Univera Setting Facility Modifier None Typical Low $7.41 Median $9.77 Typical High $9.77 | Facility | None | $7.41 | $9.77 | $9.77 |
Univera Setting Professional Modifier None Typical Low $7.41 Median $9.77 Typical High $9.77 | Professional | None | $7.41 | $9.77 | $9.77 |
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 $4.07 Median $4.07 Typical High $4.07 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.23 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.81 |
Where New York sits
Rates are fairly even across states for this service. 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· 17th of 51
$8.13
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.