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 $1,513.56 Median $4,677.35 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,677.35 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $316.23 Typical High $316.23 | Professional | None | $138.04 | $316.23 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,659.59 | $6,456.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $91.20 | Professional | None | $69.18 | $81.28 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $2,454.71 Typical High $5,011.87 | Facility | None | $1,445.44 | $2,454.71 | $5,011.87 |
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 |
Emblem Health Setting Facility Modifier None Typical Low $239.88 Median $398.11 Typical High $912.01 | Facility | None | $239.88 | $398.11 | $912.01 |
Emblem Health Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $457.09 | Professional | None | $165.96 | $263.03 | $457.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $398.11 | Professional | None | $213.80 | $213.80 | $398.11 |
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 $181.97 Median $281.84 Typical High $691.83 | Professional | None | $181.97 | $281.84 | $691.83 |
Univera Setting Facility Modifier None Typical Low $181.97 Median $213.80 Typical High $213.80 | Facility | None | $181.97 | $213.80 | $213.80 |
Univera Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $316.23 | Professional | None | $128.82 | $213.80 | $316.23 |
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 $69.18 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $69.18 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $28.18 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $104.71 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $20.89 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $13.80 | $31.62 | $31.62 |
Where New York sits
The same service costs 19.5 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
$91.20
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.