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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,737.80 Typical High $1,737.80 | Professional | None | $954.99 | $1,737.80 | $1,737.80 |
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 $954.99 Median $1,174.90 Typical High $1,348.96 | Professional | None | $954.99 | $1,174.90 | $1,348.96 |
CDPHP Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $10,232.93 Typical High $16,595.87 | Facility | None | $1,288.25 | $10,232.93 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $6,918.31 Typical High $6,918.31 | Professional | None | $1,380.38 | $6,918.31 | $6,918.31 |
Emblem Health Setting Facility Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $6,025.60 | Facility | None | $1,584.89 | $2,754.23 | $6,025.60 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $3,388.44 | Professional | None | $1,096.48 | $1,698.24 | $3,388.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,348.96 | $2,398.83 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $4,073.80 | Professional | None | $1,202.26 | $1,621.81 | $4,073.80 |
Univera Setting Facility Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,412.54 | Facility | None | $1,174.90 | $1,348.96 | $1,412.54 |
Univera Setting Professional Modifier None Typical Low $812.83 Median $1,348.96 Typical High $2,398.83 | Professional | None | $812.83 | $1,348.96 | $2,398.83 |
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 $478.63 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $478.63 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $190.55 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $724.44 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $144.54 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $95.50 | $173.78 | $173.78 |
Where New York sits
The same service costs 6.8 times more in Alaska than in Arkansas. 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· 48th of 51
$1,288
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.