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 $2,951.21 Median $7,413.10 Typical High $15,848.93 | Facility | None | $2,951.21 | $7,413.10 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,584.89 Typical High $6,309.57 | Professional | None | $912.01 | $1,584.89 | $6,309.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $7,413.10 Typical High $14,454.40 | Facility | None | $1,659.59 | $7,413.10 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,122.02 | Professional | None | $812.83 | $977.24 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $10,000.00 Typical High $16,595.87 | Facility | None | $1,778.28 | $10,000.00 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,709.64 | $8,709.64 | $8,709.64 |
Emblem Health Setting Facility Modifier None Typical Low $331.13 Median $575.44 Typical High $1,288.25 | Facility | None | $331.13 | $575.44 | $1,288.25 |
Emblem Health Setting Professional Modifier None Typical Low $1,288.25 Median $2,041.74 Typical High $3,548.13 | Professional | None | $1,288.25 | $2,041.74 | $3,548.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,584.89 | $1,584.89 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $13,182.57 | Facility | None | $1,318.26 | $4,073.80 | $13,182.57 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $3,890.45 | Professional | None | $1,258.93 | $1,698.24 | $3,890.45 |
Univera Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $1,584.89 | Facility | None | $288.40 | $288.40 | $1,584.89 |
Univera Setting Professional Modifier None Typical Low $954.99 Median $1,584.89 Typical High $2,818.38 | Professional | None | $954.99 | $1,584.89 | $2,818.38 |
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 $457.09 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $457.09 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $181.97 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $134.90 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $91.20 | $158.49 | $158.49 |
Where New York sits
The same service costs 9.1 times more in Oklahoma 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
$1,122
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.