How much rates vary
Facilitymedian $36 · 10th to 90th $36 to $63Professionalmedian $36 · 10th to 90th $36 to $49
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 $36.31 Median $43.65 Typical High $104.71 | Facility | None | $36.31 | $43.65 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Ambetter Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $37.15 | Facility | None | $36.31 | $36.31 | $37.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
CDPHP Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $47.86 Typical High $54.95 | Facility | None | $39.81 | $47.86 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $41.69 Typical High $77.62 | Facility | None | $34.67 | $41.69 | $77.62 |
Emblem Health Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $39.81 | Professional | None | $38.02 | $38.02 | $39.81 |
Excellus BCBS Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Highmark BCBS Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
MVP Health Care Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $102.33 | Facility | None | $46.77 | $46.77 | $102.33 |
MVP Health Care Setting Professional Modifier None Typical Low $39.81 Median $46.77 Typical High $46.77 | Professional | None | $39.81 | $46.77 | $46.77 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $36.31 Median $38.90 Typical High $48.98 | Professional | None | $36.31 | $38.90 | $48.98 |
Univera Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $39.81 | Facility | None | $36.31 | $36.31 | $39.81 |
Univera Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
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 $18.20 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
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· 47th of 51
$36.31
AK $50.12GA $36.31
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.