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 $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $2,089.30 Typical High $2,089.30 | Professional | None | $263.03 | $2,089.30 | $2,089.30 |
CDPHP Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $186.21 Typical High $426.58 | Facility | None | $138.04 | $186.21 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Emblem Health Setting Facility Modifier None Typical Low $151.36 Median $537.03 Typical High $3,388.44 | Facility | None | $151.36 | $537.03 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $2,818.38 Typical High $2,818.38 | Professional | None | $263.03 | $2,818.38 | $2,818.38 |
Excellus BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,818.38 | $2,951.21 | $2,951.21 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,951.21 | Professional | None | $2,818.38 | $2,818.38 | $2,951.21 |
MVP Health Care Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $6,025.60 | Facility | None | $2,818.38 | $2,818.38 | $6,025.60 |
MVP Health Care Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $2,398.83 | Professional | None | $177.83 | $288.40 | $2,398.83 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Professional | None | $125.89 | $125.89 | $173.78 |
Univera Setting Facility Modifier None Typical Low $2,818.38 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,818.38 | $2,951.21 | $2,951.21 |
Univera Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,951.21 | Professional | None | $2,818.38 | $2,818.38 | $2,951.21 |
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 $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $208.93 |
Where New York sits
The same service costs 24.0 times more in Wyoming than in North Carolina. 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· 11th of 51
$2,089
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.