How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $245.47 Median $295.12 Typical High $309.03 | Facility | None | $245.47 | $295.12 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $295.12 | Professional | None | $245.47 | $295.12 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $125.89 | Professional | None | $95.50 | $112.20 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Excellus BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
MVP Health Care Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $1,047.13 | Professional | None | $512.86 | $602.56 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,584.89 | Facility | None | $1,096.48 | $1,288.25 | $1,584.89 |
United Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Univera Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $151.36 | Facility | None | $56.23 | $56.23 | $151.36 |
Univera Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | None | $56.23 | $56.23 | $56.23 |
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 $120.23 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $120.23 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $48.98 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $36.31 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $24.55 | $29.51 | $29.51 |
Where New York sits
The same service costs 25.1 times more in North Dakota than in West Virginia. 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· 32nd of 51
$112
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.