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 $1,819.70 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $851.14 Typical High $851.14 | Professional | None | $478.63 | $851.14 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $489.78 | Professional | None | $363.08 | $436.52 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,445.44 | $3,981.07 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $1,230.27 Typical High $1,230.27 | Professional | None | $239.88 | $1,230.27 | $1,230.27 |
Excellus BCBS Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $436.52 | Professional | None | $229.09 | $234.42 | $436.52 |
MVP Health Care Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,318.26 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $213.80 Median $724.44 Typical High $1,905.46 | Professional | None | $213.80 | $724.44 | $1,905.46 |
Univera Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Univera Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $407.38 | Professional | None | $138.04 | $234.42 | $407.38 |
5 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 $239.88 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $239.88 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $97.72 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $363.08 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $72.44 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $47.86 | $87.10 | $87.10 |
Where New York sits
The same service costs 12.6 times more in Ohio than in Nebraska. 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· 48th of 51
$468
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.