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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,570.40 Median $3,162.28 Typical High $3,548.13 | Professional | None | $2,570.40 | $3,162.28 | $3,548.13 |
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 |
Emblem Health Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,890.45 | Facility | None | $2,398.83 | $2,398.83 | $3,890.45 |
MVP Health Care Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $64.57 Median $1,380.38 Typical High $1,659.59 | Professional | None | $64.57 | $1,380.38 | $1,659.59 |
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 $933.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $186.21 |
Where New York sits
The same service costs 162.2 times more in Wisconsin than in Hawaii. 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· 3rd of 51
$3,020
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.