How much rates vary
Facilitymedian $331 · 10th to 90th $324 to $575Professionalmedian $331 · 10th to 90th $324 to $389
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 $323.59 Median $416.87 Typical High $933.25 | Facility | None | $323.59 | $416.87 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $331.13 | Facility | None | $323.59 | $323.59 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
CDPHP Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $426.58 Typical High $489.78 | Facility | None | $302.00 | $426.58 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Emblem Health Setting Facility Modifier None Typical Low $309.03 Median $398.11 Typical High $741.31 | Facility | None | $309.03 | $398.11 | $741.31 |
Emblem Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
Excellus BCBS Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $331.13 | Facility | None | $323.59 | $323.59 | $331.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $331.13 | Professional | None | $323.59 | $323.59 | $331.13 |
MVP Health Care Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $676.08 | Facility | None | $407.38 | $407.38 | $676.08 |
MVP Health Care Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $389.05 | Professional | None | $331.13 | $389.05 | $389.05 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $436.52 | Professional | None | $323.59 | $338.84 | $436.52 |
Univera Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $338.84 | Facility | None | $323.59 | $323.59 | $338.84 |
Univera Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $331.13 | Professional | None | $323.59 | $323.59 | $331.13 |
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 $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.11 |
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· 30th of 51
$331
AK $407VT $331
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.