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 $1,513.56 Median $4,365.16 Typical High $8,317.64 | Facility | None | $1,513.56 | $4,365.16 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $169.82 Typical High $169.82 | Professional | None | $95.50 | $169.82 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $131.83 | Professional | None | $97.72 | $117.49 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $776.25 Typical High $1,778.28 | Facility | None | $426.58 | $776.25 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $9,772.37 Median $9,772.37 Typical High $9,772.37 | Professional | None | $9,772.37 | $9,772.37 | $9,772.37 |
Emblem Health Setting Facility Modifier None Typical Low $117.49 Median $190.55 Typical High $457.09 | Facility | None | $117.49 | $190.55 | $457.09 |
Emblem Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,511.89 Typical High $3,630.78 | Professional | None | $2,344.23 | $2,511.89 | $3,630.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $34.67 Median $1,905.46 Typical High $2,398.83 | Professional | None | $34.67 | $1,905.46 | $2,398.83 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $4,897.79 | Facility | None | $549.54 | $1,737.80 | $4,897.79 |
United Setting Professional Modifier None Typical Low $89.13 Median $162.18 Typical High $1,737.80 | Professional | None | $89.13 | $162.18 | $1,737.80 |
Univera Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $2,344.23 | Facility | None | $93.33 | $93.33 | $2,344.23 |
Univera Setting Professional Modifier None Typical Low $34.67 Median $1,905.46 Typical High $2,344.23 | Professional | None | $34.67 | $1,905.46 | $2,344.23 |
4 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 $47.86 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $47.86 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $19.05 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $25.12 Typical High $25.12 | Professional | 55 · Aftercare only | $14.13 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $9.55 | $16.98 | $16.98 |
Where New York sits
The same service costs 24.5 times more in Texas than in Missouri. 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
$123
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.