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 $4,365.16 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $398.11 Typical High $398.11 | Professional | None | $47.86 | $398.11 | $398.11 |
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 $117.49 Median $147.91 Typical High $173.78 | Professional | None | $117.49 | $147.91 | $173.78 |
CDPHP Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $12,302.69 | Facility | None | $4,073.80 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $144.54 | Professional | None | $95.50 | $95.50 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $125.89 Typical High $1,318.26 | Facility | None | $74.13 | $125.89 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $489.78 Typical High $489.78 | Professional | None | $93.33 | $489.78 | $489.78 |
Emblem Health Setting Facility Modifier None Typical Low $60.26 Median $100.00 Typical High $229.09 | Facility | None | $60.26 | $100.00 | $229.09 |
Emblem Health Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $199.53 | Professional | None | $75.86 | $75.86 | $199.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $128.82 | Professional | None | $93.33 | $97.72 | $128.82 |
MVP Health Care Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $141.25 | Professional | None | $91.20 | $91.20 | $141.25 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $41.69 Median $75.86 Typical High $154.88 | Professional | None | $41.69 | $75.86 | $154.88 |
Univera Setting Facility Modifier None Typical Low $57.54 Median $61.66 Typical High $93.33 | Facility | None | $57.54 | $61.66 | $93.33 |
Univera Setting Professional Modifier None Typical Low $61.66 Median $97.72 Typical High $125.89 | Professional | None | $61.66 | $97.72 | $125.89 |
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 $23.99 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $23.99 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $9.55 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $36.31 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $7.24 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $4.79 | $39.81 | $39.81 |
Where New York sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 14th of 51
$138
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.