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 $1,905.46 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,905.46 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $602.56 Typical High $645.65 | Professional | None | $346.74 | $602.56 | $645.65 |
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 $457.09 Median $537.03 Typical High $616.60 | Professional | None | $457.09 | $537.03 | $616.60 |
CDPHP Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $15,135.61 | Facility | None | $5,011.87 | $5,011.87 | $15,135.61 |
CDPHP Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $616.60 Median $2,884.03 Typical High $2,884.03 | Professional | None | $616.60 | $2,884.03 | $2,884.03 |
Emblem Health Setting Facility Modifier None Typical Low $537.03 Median $933.25 Typical High $2,089.30 | Facility | None | $537.03 | $933.25 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $380.19 Median $575.44 Typical High $1,148.15 | Professional | None | $380.19 | $575.44 | $1,148.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $831.76 | Professional | None | $467.74 | $467.74 | $831.76 |
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 $407.38 Median $562.34 Typical High $1,445.44 | Professional | None | $407.38 | $562.34 | $1,445.44 |
Univera Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Facility | None | $467.74 | $467.74 | $467.74 |
Univera Setting Professional Modifier None Typical Low $281.84 Median $467.74 Typical High $831.76 | Professional | None | $281.84 | $467.74 | $831.76 |
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 $169.82 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $169.82 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $69.18 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $457.09 Typical High $457.09 | Professional | 54 · Surgery only | $257.04 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $91.20 Typical High $91.20 | Professional | 55 · Aftercare only | $51.29 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $34.67 | $60.26 | $60.26 |
Where New York sits
The same service costs 29.5 times more in Louisiana than in Maine. 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· 50th of 51
$589
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.