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 $131.83 Median $162.18 Typical High $389.05 | Facility | None | $131.83 | $162.18 | $389.05 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $154.88 | Professional | None | $131.83 | $131.83 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
CDPHP Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $245.47 | Facility | None | $54.95 | $54.95 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $870.96 | Professional | None | $162.18 | $162.18 | $870.96 |
Emblem Health Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $251.19 | Facility | None | $154.88 | $154.88 | $251.19 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $204.17 | Professional | None | $162.18 | $162.18 | $204.17 |
Excellus BCBS Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $162.18 | Facility | None | $154.88 | $154.88 | $162.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $162.18 | Professional | None | $154.88 | $154.88 | $162.18 |
MVP Health Care 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 $144.54 Median $165.96 Typical High $218.78 | Professional | None | $144.54 | $165.96 | $218.78 |
Univera Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $162.18 | Facility | None | $154.88 | $154.88 | $162.18 |
Univera Setting Professional Modifier None Typical Low $77.62 Median $154.88 Typical High $162.18 | Professional | None | $77.62 | $154.88 | $162.18 |
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 $66.07 Median $66.07 Typical High $77.62 | Professional | 52 · Reduced service | $66.07 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $30.90 | Professional | 53 · Discontinued | $26.30 | $26.30 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $22.91 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $15.49 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $15.49 |
Where New York sits
The same service costs 4.4 times more in Alaska 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· 37th of 51
$158
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.