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 $2,570.40 Median $7,079.46 Typical High $14,454.40 | Facility | None | $2,570.40 | $7,079.46 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $61.66 Typical High $6,309.57 | Professional | None | $34.67 | $61.66 | $6,309.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $346.74 | Professional | None | $229.09 | $275.42 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $11,481.54 Typical High $23,442.29 | Facility | None | $1,445.44 | $11,481.54 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $1,819.70 Typical High $1,819.70 | Professional | None | $331.13 | $1,819.70 | $1,819.70 |
Excellus BCBS Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $616.60 | Professional | None | $346.74 | $346.74 | $616.60 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,677.35 Typical High $15,488.17 | Facility | None | $1,380.38 | $4,677.35 | $15,488.17 |
United Setting Professional Modifier None Typical Low $50.12 Median $97.72 Typical High $398.11 | Professional | None | $50.12 | $97.72 | $398.11 |
Univera Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Univera Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $616.60 | Professional | None | $208.93 | $346.74 | $616.60 |
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 $17.38 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $17.38 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $7.08 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $46.77 Typical High $46.77 | Professional | 54 · Surgery only | $26.30 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $5.25 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $3.47 | $6.17 | $6.17 |
Where New York sits
The same service costs 93.3 times more in Oregon than in Vermont. 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· 43rd of 51
$288
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.