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 $1,819.70 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $97.72 Typical High $97.72 | Professional | None | $56.23 | $97.72 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,709.64 Typical High $15,848.93 | Facility | None | $1,778.28 | $8,709.64 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $707.95 | Professional | None | $512.86 | $630.96 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $7,762.47 Typical High $28,840.32 | Facility | None | $1,288.25 | $7,762.47 | $28,840.32 |
Cigna Setting Professional Modifier None Typical Low $12,302.69 Median $12,302.69 Typical High $12,302.69 | Professional | None | $12,302.69 | $12,302.69 | $12,302.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $3,235.94 | Professional | None | $1,819.70 | $2,454.71 | $3,235.94 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $35.48 Median $89.13 Typical High $234.42 | Professional | None | $35.48 | $89.13 | $234.42 |
Univera Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Univera Setting Professional Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $3,235.94 | Professional | None | $1,096.48 | $2,454.71 | $3,235.94 |
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 $28.18 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $28.18 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $11.22 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $8.51 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $9.77 Typical High $9.77 | Professional | 56 · Pre-op care only | $5.62 | $9.77 | $9.77 |
Where New York sits
The same service costs 30.9 times more in California than in Idaho. 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· 19th of 51
$646
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.