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 $426.58 Median $630.96 Typical High $1,230.27 | Facility | None | $426.58 | $630.96 | $1,230.27 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $489.78 | Professional | None | $426.58 | $426.58 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $562.34 | Facility | None | $537.03 | $537.03 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
CDPHP Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $549.54 Typical High $776.25 | Facility | None | $524.81 | $549.54 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $2,754.23 | Professional | None | $524.81 | $524.81 | $2,754.23 |
Emblem Health Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $851.14 | Facility | None | $524.81 | $524.81 | $851.14 |
Emblem Health Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $645.65 | Professional | None | $524.81 | $524.81 | $645.65 |
Excellus BCBS Setting Facility Modifier None Typical Low $524.81 Median $537.03 Typical High $537.03 | Facility | None | $524.81 | $537.03 | $537.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | None | $524.81 | $537.03 | $537.03 |
MVP Health Care Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Facility | None | $1,122.02 | $1,122.02 | $1,122.02 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
United Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $691.83 | Professional | None | $512.86 | $537.03 | $691.83 |
Univera Setting Facility Modifier None Typical Low $524.81 Median $537.03 Typical High $537.03 | Facility | None | $524.81 | $537.03 | $537.03 |
Univera Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | None | $524.81 | $537.03 | $537.03 |
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 $213.80 Median $213.80 Typical High $245.47 | Professional | 52 · Reduced service | $213.80 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $97.72 | Professional | 53 · Discontinued | $85.11 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $74.13 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $48.98 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $48.98 |
Where New York sits
The same service costs 1.7 times more in Arizona than in Hawaii. 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· 50th of 51
$513
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.