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 $5,754.40 Typical High $10,232.93 | Facility | None | $1,819.70 | $5,754.40 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $281.84 | Professional | None | $162.18 | $281.84 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $51.29 Typical High $57.54 | Professional | None | $43.65 | $51.29 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,737.80 Typical High $1,862.09 | Facility | None | $676.08 | $1,737.80 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
Emblem Health Setting Facility Modifier None Typical Low $169.82 Median $275.42 Typical High $645.65 | Facility | None | $169.82 | $275.42 | $645.65 |
Emblem Health Setting Professional Modifier None Typical Low $181.97 Median $186.21 Typical High $295.12 | Professional | None | $181.97 | $186.21 | $295.12 |
Excellus BCBS Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $218.78 | Professional | None | $151.36 | $151.36 | $218.78 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $234.42 | Professional | None | $117.49 | $147.91 | $234.42 |
Univera Setting Facility Modifier None Typical Low $128.82 Median $151.36 Typical High $151.36 | Facility | None | $128.82 | $151.36 | $151.36 |
Univera Setting Professional Modifier None Typical Low $91.20 Median $151.36 Typical High $218.78 | Professional | None | $91.20 | $151.36 | $218.78 |
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 $81.28 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $81.28 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $32.36 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $123.03 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $24.55 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $16.22 | $28.18 | $28.18 |
Where New York sits
The same service costs 18.6 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
$56.23
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.