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 $57.54 Median $97.72 Typical High $100.00 | Facility | None | $57.54 | $97.72 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $100.00 Typical High $100.00 | Professional | None | $57.54 | $100.00 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $70.79 | Professional | None | $53.70 | $63.10 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $134.90 | Professional | None | $79.43 | $87.10 | $134.90 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,981.07 Typical High $10,232.93 | Facility | None | $1,479.11 | $3,981.07 | $10,232.93 |
United Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $123.03 | Professional | None | $63.10 | $87.10 | $123.03 |
Univera Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Univera Setting Professional Modifier None Typical Low $46.77 Median $87.10 Typical High $134.90 | Professional | None | $46.77 | $87.10 | $134.90 |
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 $28.84 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $28.84 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $11.48 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $8.71 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.75 | $10.00 | $10.00 |
Where New York sits
The same service costs 12.6 times more in California 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· 48th of 51
$66.07
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.