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 $5,248.07 Typical High $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,513.56 Typical High $1,513.56 | Professional | None | $891.25 | $1,513.56 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $36.31 Typical High $56.23 | Professional | None | $30.90 | $36.31 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Professional | None | $6,456.54 | $6,456.54 | $6,456.54 |
Emblem Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,348.96 Typical High $2,290.87 | Professional | None | $741.31 | $1,348.96 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,398.83 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,398.83 | $7,244.36 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $4,073.80 | Professional | None | $1,122.02 | $1,513.56 | $4,073.80 |
Univera Setting Facility Modifier None Typical Low $741.31 Median $1,513.56 Typical High $1,737.80 | Facility | None | $741.31 | $1,513.56 | $1,737.80 |
Univera Setting Professional Modifier None Typical Low $741.31 Median $1,258.93 Typical High $2,089.30 | Professional | None | $741.31 | $1,258.93 | $2,089.30 |
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 $446.68 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $446.68 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $177.83 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $676.08 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $134.90 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $89.13 | $151.36 | $151.36 |
Where New York sits
The same service costs 109.6 times more in Alaska 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
$741
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.