How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $40.74 Median $46.77 Typical High $102.33 | Facility | None | $40.74 | $46.77 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $40.74 | Professional | None | $35.48 | $35.48 | $40.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.02 Median $0.03 Typical High $40.74 | Professional | None | $0.02 | $0.03 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $33.11 Typical High $47.86 | Facility | None | $30.20 | $33.11 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
Emblem Health Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $67.61 | Facility | None | $41.69 | $41.69 | $67.61 |
Emblem Health Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $51.29 | Professional | None | $45.71 | $45.71 | $51.29 |
Excellus BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
MVP Health Care Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $40.74 Median $42.66 Typical High $53.70 | Professional | None | $40.74 | $42.66 | $53.70 |
Univera Setting Facility Modifier None Typical Low $37.15 Median $42.66 Typical High $42.66 | Facility | None | $37.15 | $42.66 | $42.66 |
Univera Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
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 $17.38 Median $17.38 Typical High $20.42 | Professional | 52 · Reduced service | $17.38 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $8.13 | Professional | 53 · Discontinued | $7.08 | $7.08 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $6.17 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $4.07 |
Where New York sits
The same service costs 2.0 times more in Alaska than in New Mexico. 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· 49th of 51
$35.48
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.