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 $53.70 Median $69.18 Typical High $154.88 | Facility | None | $53.70 | $69.18 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $54.95 | Facility | None | $53.70 | $53.70 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
CDPHP Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $74.13 Typical High $85.11 | Facility | None | $61.66 | $74.13 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
Emblem Health Setting Facility Modifier None Typical Low $53.70 Median $67.61 Typical High $125.89 | Facility | None | $53.70 | $67.61 | $125.89 |
Emblem Health Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Excellus BCBS Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Excellus BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
MVP Health Care Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $117.49 | Facility | None | $64.57 | $64.57 | $117.49 |
MVP Health Care Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $61.66 | Professional | None | $51.29 | $61.66 | $61.66 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $53.70 Median $56.23 Typical High $70.79 | Professional | None | $53.70 | $56.23 | $70.79 |
Univera Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $56.23 | Facility | None | $53.70 | $53.70 | $56.23 |
Univera Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
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 $28.18 Median $28.18 Typical High $28.18 | Professional | 52 · Reduced service | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.62 |
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· 22nd of 51
$56.23
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.