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 $32.36 Median $38.90 Typical High $95.50 | Facility | None | $32.36 | $38.90 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $33.88 | Facility | None | $32.36 | $32.36 | $33.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $42.66 Typical High $48.98 | Facility | None | $35.48 | $42.66 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Emblem Health Setting Facility Modifier None Typical Low $30.90 Median $35.48 Typical High $69.18 | Facility | None | $30.90 | $35.48 | $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 Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $33.11 | Facility | None | $32.36 | $32.36 | $33.11 |
Excellus BCBS Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $33.11 | Professional | None | $32.36 | $32.36 | $33.11 |
MVP Health Care Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $67.61 | Facility | None | $41.69 | $41.69 | $67.61 |
MVP Health Care Setting Professional Modifier None Typical Low $34.67 Median $41.69 Typical High $41.69 | Professional | None | $34.67 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $34.67 | Professional | None | $30.90 | $32.36 | $34.67 |
Univera Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $33.88 | Facility | None | $32.36 | $32.36 | $33.88 |
Univera Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $33.11 | Professional | None | $32.36 | $32.36 | $33.11 |
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 $16.22 Median $16.22 Typical High $16.22 | Professional | 52 · Reduced service | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.24 |
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· 38th of 51
$32.36
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.