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 $288.40 Median $380.19 Typical High $416.87 | Professional | None | $288.40 | $380.19 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $524.81 | Professional | None | $389.05 | $467.74 | $524.81 |
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 $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $12,302.69 Typical High $24,547.09 | Facility | None | $1,445.44 | $12,302.69 | $24,547.09 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $2,089.30 Typical High $2,089.30 | Professional | None | $416.87 | $2,089.30 | $2,089.30 |
Emblem Health Setting Facility Modifier None Typical Low $436.52 Median $758.58 Typical High $1,659.59 | Facility | None | $436.52 | $758.58 | $1,659.59 |
Emblem Health Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $933.25 | Professional | None | $309.03 | $467.74 | $933.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $660.69 | Professional | None | $371.54 | $371.54 | $660.69 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,677.35 Typical High $15,848.93 | Facility | None | $1,380.38 | $4,677.35 | $15,848.93 |
United Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $933.25 | Professional | None | $302.00 | $407.38 | $933.25 |
Univera Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Univera Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $660.69 | Professional | None | $223.87 | $371.54 | $660.69 |
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 $144.54 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $144.54 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $57.54 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $288.40 Typical High $288.40 | Professional | 54 · Surgery only | $213.80 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $42.66 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $28.84 | $38.02 | $38.02 |
Where New York sits
The same service costs 16.2 times more in Arkansas than in West 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· 48th of 51
$479
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.