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 $33.88 Typical High $74.13 | Facility | None | $25.70 | $33.88 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $29.51 | Professional | None | $25.70 | $25.70 | $29.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $51.29 | Professional | None | $30.90 | $30.90 | $51.29 |
CDPHP Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $85.11 | Facility | None | $36.31 | $36.31 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Emblem Health Setting Facility Modifier None Typical Low $30.20 Median $34.67 Typical High $69.18 | Facility | None | $30.20 | $34.67 | $69.18 |
Emblem Health Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $33.88 | Professional | None | $31.62 | $31.62 | $33.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
MVP Health Care Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | None | $10.00 | $10.00 | $10.00 |
United Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $40.74 | Professional | None | $30.90 | $32.36 | $40.74 |
Univera Setting Facility Modifier None Typical Low $16.60 Median $19.05 Typical High $19.05 | Facility | None | $16.60 | $19.05 | $19.05 |
Univera Setting Professional Modifier None Typical Low $10.00 Median $19.50 Typical High $19.50 | Professional | None | $10.00 | $19.50 | $19.50 |
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 $12.59 Median $12.59 Typical High $14.79 | Professional | 52 · Reduced service | $12.59 | $12.59 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.89 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $4.47 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $2.95 |
Where New York sits
Rates are fairly even across states for this service. 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
$30.90
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.