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 $371.54 Median $616.60 Typical High $660.69 | Professional | None | $371.54 | $616.60 | $660.69 |
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 $309.03 Median $371.54 Typical High $436.52 | Professional | None | $309.03 | $371.54 | $436.52 |
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 $707.95 Median $707.95 Typical High $707.95 | Professional | None | $707.95 | $707.95 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $12,589.25 Typical High $25,703.96 | Facility | None | $1,445.44 | $12,589.25 | $25,703.96 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $2,290.87 Typical High $2,290.87 | Professional | None | $426.58 | $2,290.87 | $2,290.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $426.58 Median $436.52 Typical High $776.25 | Professional | None | $426.58 | $436.52 | $776.25 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $5,888.44 Typical High $30,902.95 | Facility | None | $1,412.54 | $5,888.44 | $30,902.95 |
United Setting Professional Modifier None Typical Low $371.54 Median $575.44 Typical High $1,479.11 | Professional | None | $371.54 | $575.44 | $1,479.11 |
Univera Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Univera Setting Professional Modifier None Typical Low $263.03 Median $436.52 Typical High $776.25 | Professional | None | $263.03 | $436.52 | $776.25 |
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 $186.21 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $186.21 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $74.13 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $281.84 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $56.23 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $37.15 | $61.66 | $61.66 |
Where New York sits
The same service costs 24.0 times more in Arkansas than in New York. 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· 51st of 51
$417
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.