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 $25.70 Median $35.48 Typical High $79.43 | Facility | None | $25.70 | $35.48 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $26.30 | Professional | None | $25.70 | $25.70 | $26.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $52.48 | Professional | None | $25.70 | $25.70 | $52.48 |
CDPHP Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $24.55 Median $33.88 Typical High $46.77 | Facility | None | $24.55 | $33.88 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $117.49 | Professional | None | $25.70 | $25.70 | $117.49 |
Emblem Health Setting Facility Modifier None Typical Low $23.99 Median $30.20 Typical High $56.23 | Facility | None | $23.99 | $30.20 | $56.23 |
Emblem Health Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $38.90 | Professional | None | $27.54 | $27.54 | $38.90 |
Excellus BCBS Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $28.84 | Facility | None | $27.54 | $27.54 | $28.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $28.84 | Professional | None | $27.54 | $27.54 | $28.84 |
MVP Health Care Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $66.07 | Facility | None | $35.48 | $35.48 | $66.07 |
MVP Health Care Setting Professional Modifier None Typical Low $29.51 Median $30.20 Typical High $30.90 | Professional | None | $29.51 | $30.20 | $30.90 |
United Setting Professional Modifier None Typical Low $27.54 Median $28.84 Typical High $50.12 | Professional | None | $27.54 | $28.84 | $50.12 |
Univera Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $28.84 | Facility | None | $27.54 | $27.54 | $28.84 |
Univera Setting Professional Modifier None Typical Low $26.30 Median $27.54 Typical High $28.84 | Professional | None | $26.30 | $27.54 | $28.84 |
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 $3.80 Median $3.80 Typical High $3.80 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $2.51 |
Where New York sits
The same service costs 1.9 times more in Alaska 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· 40th of 51
$27.54
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.