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 $2,238.72 Median $6,456.54 Typical High $13,182.57 | Facility | None | $2,238.72 | $6,456.54 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $501.19 Typical High $501.19 | Professional | None | $275.42 | $501.19 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $20,892.96 | Facility | None | $1,862.09 | $8,709.64 | $20,892.96 |
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 $30,199.52 Typical High $50,118.72 | Facility | None | $1,445.44 | $30,199.52 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $1,778.28 Typical High $1,778.28 | Professional | None | $331.13 | $1,778.28 | $1,778.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $338.84 Median $346.74 Typical High $602.56 | Professional | None | $338.84 | $346.74 | $602.56 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $5,888.44 Typical High $36,307.81 | Facility | None | $1,412.54 | $5,888.44 | $36,307.81 |
United Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $1,174.90 | Professional | None | $288.40 | $446.68 | $1,174.90 |
Univera Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Univera Setting Professional Modifier None Typical Low $204.17 Median $346.74 Typical High $602.56 | Professional | None | $204.17 | $346.74 | $602.56 |
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 $138.04 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $138.04 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $56.23 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $208.93 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $41.69 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $27.54 | $50.12 | $50.12 |
Where New York sits
The same service costs 57.5 times more in Arkansas 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
$309
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.