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 $239.88 Median $398.11 Typical High $426.58 | Professional | None | $239.88 | $398.11 | $426.58 |
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 $354.81 Median $416.87 Typical High $467.74 | Professional | None | $354.81 | $416.87 | $467.74 |
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 $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
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 $354.81 Median $1,778.28 Typical High $1,778.28 | Professional | None | $354.81 | $1,778.28 | $1,778.28 |
Emblem Health Setting Facility Modifier None Typical Low $380.19 Median $660.69 Typical High $1,479.11 | Facility | None | $380.19 | $660.69 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $812.83 | Professional | None | $269.15 | $407.38 | $812.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $575.44 | Professional | None | $331.13 | $331.13 | $575.44 |
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 $288.40 Median $389.05 Typical High $954.99 | Professional | None | $288.40 | $389.05 | $954.99 |
Univera Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Univera Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $575.44 | Professional | None | $199.53 | $331.13 | $575.44 |
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 $120.23 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $120.23 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $47.86 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $181.97 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $36.31 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $23.99 | $39.81 | $39.81 |
Where New York sits
The same service costs 15.8 times more in Arkansas 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· 49th of 51
$437
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.