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 $1,348.96 Median $5,248.07 Typical High $10,471.29 | Facility | None | $1,348.96 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $79.43 | Professional | None | $66.07 | $66.07 | $79.43 |
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 $50.12 Median $60.26 Typical High $77.62 | Professional | None | $50.12 | $60.26 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $676.08 Typical High $1,380.38 | Facility | None | $100.00 | $676.08 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $97.72 Typical High $138.04 | Professional | None | $51.29 | $97.72 | $138.04 |
Emblem Health Setting Facility Modifier None Typical Low $74.13 Median $102.33 Typical High $223.87 | Facility | None | $74.13 | $102.33 | $223.87 |
Emblem Health Setting Professional Modifier None Typical Low $19.50 Median $69.18 Typical High $89.13 | Professional | None | $19.50 | $69.18 | $89.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $27.54 Median $64.57 Typical High $91.20 | Professional | None | $27.54 | $64.57 | $91.20 |
MVP Health Care Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
MVP Health Care Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,412.54 Typical High $4,365.16 | Facility | None | $363.08 | $1,412.54 | $4,365.16 |
United Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $128.82 | Professional | None | $46.77 | $72.44 | $128.82 |
Univera Setting Facility Modifier None Typical Low $19.50 Median $57.54 Typical High $120.23 | Facility | None | $19.50 | $57.54 | $120.23 |
Univera Setting Professional Modifier None Typical Low $27.54 Median $64.57 Typical High $91.20 | Professional | None | $27.54 | $64.57 | $91.20 |
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 $33.11 Median $33.11 Typical High $34.67 | Professional | 52 · Reduced service | $33.11 | $33.11 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $14.13 | Professional | 53 · Discontinued | $13.18 | $13.18 | $14.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $52.48 | Professional | 54 · Surgery only | $48.98 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $10.47 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $7.08 |
Where New York sits
The same service costs 5.5 times more in Arkansas 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
$63.10
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.