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 $1,737.80 Median $4,570.88 Typical High $8,317.64 | Facility | None | $1,737.80 | $4,570.88 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $21.88 Typical High $6,309.57 | Professional | None | $19.05 | $21.88 | $6,309.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $181.97 | Professional | None | $138.04 | $162.18 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $15.14 Median $19.50 Typical High $31.62 | Professional | None | $15.14 | $19.50 | $31.62 |
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 $9.33 Median $10.72 Typical High $63.10 | Professional | 52 · Reduced service | $9.33 | $10.72 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $4.27 Typical High $25.12 | Professional | 53 · Discontinued | $3.72 | $4.27 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.13 Median $15.85 Typical High $95.50 | Professional | 54 · Surgery only | $14.13 | $15.85 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $3.24 Typical High $19.05 | Professional | 55 · Aftercare only | $2.82 | $3.24 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $2.14 Typical High $12.59 | Professional | 56 · Pre-op care only | $1.86 | $2.14 | $12.59 |
Where New York sits
The same service costs 14.5 times more in New Hampshire than in New Jersey. 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· 6th of 51
$155
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.