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 $416.87 Median $416.87 Typical High $660.69 | Professional | None | $416.87 | $416.87 | $660.69 |
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 $281.84 Median $338.84 Typical High $389.05 | Professional | None | $281.84 | $338.84 | $389.05 |
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 $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $8,317.64 Typical High $16,982.44 | Facility | None | $1,445.44 | $8,317.64 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $3,981.07 Typical High $3,981.07 | Professional | None | $691.83 | $3,981.07 | $3,981.07 |
Emblem Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,737.80 Typical High $3,801.89 | Facility | None | $1,000.00 | $1,737.80 | $3,801.89 |
Emblem Health Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $2,137.96 | Professional | None | $691.83 | $1,047.13 | $2,137.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,513.56 | Professional | None | $851.14 | $851.14 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,162.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $346.74 Median $602.56 Typical High $1,230.27 | Professional | None | $346.74 | $602.56 | $1,230.27 |
Univera Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
Univera Setting Professional Modifier None Typical Low $512.86 Median $851.14 Typical High $1,513.56 | Professional | None | $512.86 | $851.14 | $1,513.56 |
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 $208.93 Median $208.93 Typical High $234.42 | Professional | 52 · Reduced service | $208.93 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $95.50 | Professional | 53 · Discontinued | $83.18 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $354.81 | Professional | 54 · Surgery only | $309.03 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $70.79 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $47.86 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $47.86 |
Where New York sits
The same service costs 14.8 times more in Texas 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
$389
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.