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 $691.83 Median $891.25 Typical High $1,995.26 | Facility | None | $691.83 | $891.25 | $1,995.26 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $707.95 | Facility | None | $691.83 | $691.83 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
CDPHP Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $912.01 Typical High $1,023.29 | Facility | None | $758.58 | $912.01 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Emblem Health Setting Facility Modifier None Typical Low $645.65 Median $776.25 Typical High $2,344.23 | Facility | None | $645.65 | $776.25 | $2,344.23 |
Emblem Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $741.31 | Professional | None | $691.83 | $691.83 | $741.31 |
Excellus BCBS Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $707.95 | Facility | None | $691.83 | $691.83 | $707.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $707.95 | Professional | None | $691.83 | $691.83 | $707.95 |
MVP Health Care Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,445.44 | Facility | None | $870.96 | $870.96 | $1,445.44 |
MVP Health Care Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $812.83 | Professional | None | $676.08 | $812.83 | $812.83 |
United Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
United Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $912.01 | Professional | None | $691.83 | $724.44 | $912.01 |
Univera Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $724.44 | Facility | None | $691.83 | $691.83 | $724.44 |
Univera Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $707.95 | Professional | None | $691.83 | $691.83 | $707.95 |
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 $338.84 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
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· 34th of 51
$692
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.