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 $2,089.30 Median $6,309.57 Typical High $12,022.64 | Facility | None | $2,089.30 | $6,309.57 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,000.00 | Professional | None | $562.34 | $1,000.00 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $398.11 | Professional | None | $288.40 | $354.81 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $33,884.42 Typical High $50,118.72 | Facility | None | $1,445.44 | $33,884.42 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $602.56 | Professional | None | $263.03 | $398.11 | $602.56 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $5,888.44 Typical High $36,307.81 | Facility | None | $1,412.54 | $5,888.44 | $36,307.81 |
United Setting Professional Modifier None Typical Low $288.40 Median $891.25 Typical High $2,187.76 | Professional | None | $288.40 | $891.25 | $2,187.76 |
Univera Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $478.63 | Facility | None | $263.03 | $263.03 | $478.63 |
Univera Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $524.81 | Professional | None | $263.03 | $346.74 | $524.81 |
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 $281.84 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $281.84 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $112.20 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $426.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $85.11 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $56.23 | $100.00 | $100.00 |
Where New York sits
The same service costs 50.1 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
$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.