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 $2,238.72 Median $6,456.54 Typical High $13,182.57 | Facility | None | $2,238.72 | $6,456.54 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,348.96 Typical High $1,348.96 | Professional | None | $758.58 | $1,348.96 | $1,348.96 |
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 $302.00 Median $371.54 Typical High $416.87 | Professional | None | $302.00 | $371.54 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $11,748.98 Typical High $16,595.87 | Facility | None | $1,318.26 | $11,748.98 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,495.41 | $5,495.41 | $5,495.41 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,047.13 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,677.35 Typical High $15,848.93 | Facility | None | $1,380.38 | $4,677.35 | $15,848.93 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $3,235.94 | Professional | None | $954.99 | $1,288.25 | $3,235.94 |
Univera Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Univera Setting Professional Modifier None Typical Low $630.96 Median $1,047.13 Typical High $1,819.70 | Professional | None | $630.96 | $1,047.13 | $1,819.70 |
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 $380.19 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $380.19 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $151.36 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $114.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $75.86 | $134.90 | $134.90 |
Where New York sits
The same service costs 18.2 times more in California 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
$417
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.