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 $75.86 Median $131.83 Typical High $7,585.78 | Professional | None | $75.86 | $131.83 | $7,585.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $4,466.84 Typical High $9,120.11 | Facility | None | $2,570.40 | $4,466.84 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $169.82 | Professional | None | $123.03 | $147.91 | $169.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $223.87 Typical High $257.04 | Professional | 50 · Both sides | $181.97 | $223.87 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Emblem Health Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $380.19 | Facility | None | $100.00 | $162.18 | $380.19 |
Emblem Health Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $389.05 | Professional | None | $138.04 | $208.93 | $389.05 |
Excellus BCBS Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $158.49 | Professional | None | $109.65 | $109.65 | $158.49 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $4,570.88 Typical High $9,772.37 | Facility | None | $2,137.96 | $4,570.88 | $9,772.37 |
United Setting Professional Modifier None Typical Low $104.71 Median $131.83 Typical High $257.04 | Professional | None | $104.71 | $131.83 | $257.04 |
Univera Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Univera Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $251.19 | Professional | None | $89.13 | $109.65 | $251.19 |
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 $38.02 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $38.02 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $15.49 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $97.72 Typical High $97.72 | Professional | 54 · Surgery only | $57.54 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $11.48 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $7.59 | $13.18 | $13.18 |
Where New York sits
The same service costs 51.3 times more in Oklahoma 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· 37th of 51
$162
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.