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 $74.13 Median $87.10 Typical High $117.49 | Facility | None | $74.13 | $87.10 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $112.20 | Professional | None | $74.13 | $74.13 | $112.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $61.66 | Professional | None | $46.77 | $54.95 | $61.66 |
CDPHP Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
Emblem Health Setting Facility Modifier None Typical Low $144.54 Median $239.88 Typical High $524.81 | Facility | None | $144.54 | $239.88 | $524.81 |
Emblem Health Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $208.93 | Professional | None | $158.49 | $158.49 | $208.93 |
Excellus BCBS Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $123.03 | Professional | None | $91.20 | $102.33 | $123.03 |
MVP Health Care Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
United Setting Professional Modifier None Typical Low $56.23 Median $87.10 Typical High $95.50 | Professional | None | $56.23 | $87.10 | $95.50 |
Univera Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Facility | None | $144.54 | $144.54 | $144.54 |
Univera Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $144.54 | Professional | None | $91.20 | $102.33 | $144.54 |
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 $37.15 Median $37.15 Typical High $56.23 | Professional | 52 · Reduced service | $37.15 | $37.15 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $22.39 | Professional | 53 · Discontinued | $14.79 | $14.79 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $16.60 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $11.22 |
Where New York sits
The same service costs 3.0 times more in California than in New York. 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· 51st of 51
$58.88
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.