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 $1,621.81 Median $5,011.87 Typical High $9,120.11 | Facility | None | $1,621.81 | $5,011.87 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $446.68 Typical High $446.68 | Professional | None | $251.19 | $446.68 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $109.65 | Professional | None | $83.18 | $100.00 | $109.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $134.90 Median $154.88 Typical High $173.78 | Professional | 50 · Both sides | $134.90 | $154.88 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,445.44 | $3,981.07 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $537.03 | Professional | None | $323.59 | $407.38 | $537.03 |
Highmark BCBS Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $851.14 | Professional | None | $275.42 | $389.05 | $851.14 |
Univera Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Univera Setting Professional Modifier None Typical Low $194.98 Median $407.38 Typical High $489.78 | Professional | None | $194.98 | $407.38 | $489.78 |
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 $125.89 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $125.89 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $50.12 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $190.55 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $38.02 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $25.12 | $44.67 | $44.67 |
Where New York sits
The same service costs 28.2 times more in Texas 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· 50th of 51
$110
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.