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 $1,995.26 Median $5,754.40 Typical High $10,964.78 | Facility | None | $1,995.26 | $5,754.40 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,380.38 | $2,344.23 | $2,344.23 |
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 $1,584.89 Median $1,949.84 Typical High $2,238.72 | Professional | None | $1,584.89 | $1,949.84 | $2,238.72 |
CDPHP Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $16,595.87 | Facility | None | $5,495.41 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $3,630.78 Typical High $7,413.10 | Facility | None | $1,737.80 | $3,630.78 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $7,762.47 Typical High $7,762.47 | Professional | None | $1,548.82 | $7,762.47 | $7,762.47 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $2,630.27 | Professional | None | $1,479.11 | $1,513.56 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,332.54 | Facility | None | $1,230.27 | $3,162.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $5,370.32 | Professional | None | $1,348.96 | $2,137.96 | $5,370.32 |
Univera Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Univera Setting Professional Modifier None Typical Low $891.25 Median $1,513.56 Typical High $2,630.27 | Professional | None | $891.25 | $1,513.56 | $2,630.27 |
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 $691.83 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $691.83 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $281.84 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,047.13 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $208.93 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $138.04 | $234.42 | $234.42 |
Where New York sits
The same service costs 15.8 times more in Wisconsin than in Nebraska. 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· 40th of 51
$2,042
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.