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 $181.97 Median $323.59 Typical High $323.59 | Professional | None | $181.97 | $323.59 | $323.59 |
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 $194.98 Median $229.09 Typical High $257.04 | Professional | None | $194.98 | $229.09 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $19,952.62 Typical High $40,738.03 | Facility | None | $1,445.44 | $19,952.62 | $40,738.03 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $1,230.27 Typical High $1,230.27 | Professional | None | $239.88 | $1,230.27 | $1,230.27 |
Emblem Health Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $389.05 | Professional | None | $229.09 | $234.42 | $389.05 |
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 $165.96 Median $316.23 Typical High $707.95 | Professional | None | $165.96 | $316.23 | $707.95 |
Univera Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Facility | None | $234.42 | $234.42 | $234.42 |
Univera Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $346.74 | Professional | None | $138.04 | $229.09 | $346.74 |
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 $89.13 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $89.13 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $64.57 Typical High $64.57 | Professional | 53 · Discontinued | $36.31 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $239.88 Typical High $239.88 | Professional | 54 · Surgery only | $134.90 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $26.92 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $32.36 Typical High $32.36 | Professional | 56 · Pre-op care only | $18.20 | $32.36 | $32.36 |
Where New York sits
The same service costs 9.5 times more in Arkansas than in Kentucky. 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· 49th of 51
$234
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.