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 $389.05 Median $501.19 Typical High $1,122.02 | Facility | None | $389.05 | $501.19 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $436.52 | Professional | None | $389.05 | $389.05 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $398.11 | Facility | None | $389.05 | $389.05 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $407.38 | Professional | None | $389.05 | $389.05 | $407.38 |
CDPHP Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $512.86 Typical High $588.84 | Facility | None | $416.87 | $512.86 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | None | $389.05 | $389.05 | $416.87 |
Emblem Health Setting Facility Modifier None Typical Low $363.08 Median $467.74 Typical High $870.96 | Facility | None | $363.08 | $467.74 | $870.96 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $512.86 | Professional | None | $338.84 | $426.58 | $512.86 |
Excellus BCBS Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $407.38 | Facility | None | $389.05 | $389.05 | $407.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | None | $389.05 | $407.38 | $407.38 |
MVP Health Care Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $870.96 | Facility | None | $501.19 | $501.19 | $870.96 |
MVP Health Care Setting Professional Modifier None Typical Low $389.05 Median $501.19 Typical High $501.19 | Professional | None | $389.05 | $501.19 | $501.19 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $154.88 Median $389.05 Typical High $446.68 | Professional | None | $154.88 | $389.05 | $446.68 |
Univera Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $407.38 | Facility | None | $389.05 | $389.05 | $407.38 |
Univera Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $407.38 | Professional | None | $389.05 | $407.38 | $407.38 |
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 $194.98 Median $194.98 Typical High $199.53 | Professional | 52 · Reduced service | $194.98 | $194.98 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $79.43 | Professional | 53 · Discontinued | $77.62 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $39.81 |
Where New York sits
The same service costs 1.7 times more in Alaska than in Oklahoma. 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· 31st of 51
$389
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.