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 $1,548.82 Median $4,677.35 Typical High $10,471.29 | Facility | None | $1,548.82 | $4,677.35 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $416.87 | Professional | None | $323.59 | $380.19 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $44,668.36 Typical High $56,234.13 | Facility | None | $1,096.48 | $44,668.36 | $56,234.13 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $891.25 | Professional | None | $389.05 | $389.05 | $891.25 |
Emblem Health Setting Facility Modifier None Typical Low $354.81 Median $1,513.56 Typical High $18,197.01 | Facility | None | $354.81 | $1,513.56 | $18,197.01 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $1,445.44 | Professional | None | $870.96 | $912.01 | $1,445.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $186.21 Median $346.74 Typical High $660.69 | Professional | None | $186.21 | $346.74 | $660.69 |
MVP Health Care Setting Facility Modifier None Typical Low $26,302.68 Median $26,302.68 Typical High $38,018.94 | Facility | None | $26,302.68 | $26,302.68 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | None | $407.38 | $407.38 | $407.38 |
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 $245.47 Median $398.11 Typical High $954.99 | Professional | None | $245.47 | $398.11 | $954.99 |
Univera Setting Facility Modifier None Typical Low $218.78 Median $660.69 Typical High $2,041.74 | Facility | None | $218.78 | $660.69 | $2,041.74 |
Univera Setting Professional Modifier None Typical Low $186.21 Median $346.74 Typical High $660.69 | Professional | None | $186.21 | $346.74 | $660.69 |
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 $199.53 Median $199.53 Typical High $204.17 | Professional | 52 · Reduced service | $199.53 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $302.00 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $40.74 |
Where New York sits
The same service costs 4.6 times more in Alaska than in Florida. 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
$389
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.