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 $6,309.57 Typical High $11,748.98 | Facility | None | $1,905.46 | $6,309.57 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,905.46 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,778.28 | $6,760.83 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,801.89 Median $4,466.84 Typical High $5,011.87 | Professional | None | $3,801.89 | $4,466.84 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $12,022.64 Typical High $24,547.09 | Facility | None | $1,737.80 | $12,022.64 | $24,547.09 |
Cigna Setting Professional Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Professional | None | $6,760.83 | $6,760.83 | $6,760.83 |
Emblem Health Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,445.44 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,454.40 | Facility | None | $1,318.26 | $4,073.80 | $14,454.40 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,905.46 Typical High $4,570.88 | Professional | None | $1,047.13 | $1,905.46 | $4,570.88 |
Univera Setting Facility Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,819.70 | $1,819.70 |
Univera Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,445.44 | $1,995.26 |
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 $537.03 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $537.03 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $213.80 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $794.33 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $158.49 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $107.15 | $190.55 | $190.55 |
Where New York sits
The same service costs 4.9 times more in Alaska than in Indiana. 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· 5th of 51
$4,169
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.