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 $6,606.93 Typical High $13,803.84 | Facility | None | $2,570.40 | $6,606.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $645.65 Typical High $5,623.41 | Professional | None | $363.08 | $645.65 | $5,623.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $446.68 | Professional | None | $302.00 | $363.08 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $7,079.46 | Facility | None | $1,737.80 | $3,548.13 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $3,981.07 Typical High $3,981.07 | Professional | None | $741.31 | $3,981.07 | $3,981.07 |
Excellus BCBS Setting Professional Modifier None Typical Low $446.68 Median $776.25 Typical High $776.25 | Professional | None | $446.68 | $776.25 | $776.25 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $501.19 Median $724.44 Typical High $1,548.82 | Professional | None | $501.19 | $724.44 | $1,548.82 |
Univera Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Univera Setting Professional Modifier None Typical Low $263.03 Median $691.83 Typical High $776.25 | Professional | None | $263.03 | $691.83 | $776.25 |
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 $181.97 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $181.97 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $72.44 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $269.15 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $54.95 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $36.31 | $64.57 | $64.57 |
Where New York sits
The same service costs 10.2 times more in Texas 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
$398
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.