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 $169.82 Median $281.84 Typical High $281.84 | Professional | None | $169.82 | $281.84 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $269.15 | Professional | None | $194.98 | $234.42 | $269.15 |
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 $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $3,548.13 Typical High $7,079.46 | Facility | None | $1,445.44 | $3,548.13 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $1,202.26 Typical High $1,202.26 | Professional | None | $239.88 | $1,202.26 | $1,202.26 |
Emblem Health Setting Facility Modifier None Typical Low $275.42 Median $467.74 Typical High $1,047.13 | Facility | None | $275.42 | $467.74 | $1,047.13 |
Emblem Health Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $575.44 | Professional | None | $190.55 | $288.40 | $575.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $416.87 | Professional | None | $234.42 | $234.42 | $416.87 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $676.08 | Professional | None | $204.17 | $281.84 | $676.08 |
Univera Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Univera Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $416.87 | Professional | None | $141.25 | $234.42 | $416.87 |
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 $85.11 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $85.11 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $33.88 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $125.89 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $25.12 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $16.98 | $28.18 | $28.18 |
Where New York sits
The same service costs 10.7 times more in Colorado 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
$251
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.