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 $1,621.81 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,621.81 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $524.81 | Professional | None | $269.15 | $269.15 | $524.81 |
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 $190.55 Median $229.09 Typical High $416.87 | Professional | None | $190.55 | $229.09 | $416.87 |
CDPHP Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $2,754.23 | Facility | None | $794.33 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $239.88 Typical High $794.33 | Professional | None | $234.42 | $239.88 | $794.33 |
Emblem Health Setting Facility Modifier None Typical Low $234.42 Median $323.59 Typical High $891.25 | Facility | None | $234.42 | $323.59 | $891.25 |
Emblem Health Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $489.78 | Professional | None | $245.47 | $275.42 | $489.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $151.36 Median $208.93 Typical High $316.23 | Professional | None | $151.36 | $208.93 | $316.23 |
MVP Health Care Setting Facility Modifier None Typical Low $436.52 Median $3,235.94 Typical High $4,365.16 | Facility | None | $436.52 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $602.56 | Professional | None | $245.47 | $245.47 | $602.56 |
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 $181.97 Median $269.15 Typical High $691.83 | Professional | None | $181.97 | $269.15 | $691.83 |
Univera Setting Facility Modifier None Typical Low $162.18 Median $245.47 Typical High $426.58 | Facility | None | $162.18 | $245.47 | $426.58 |
Univera Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $316.23 | Professional | None | $151.36 | $245.47 | $316.23 |
4 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 $134.90 Median $134.90 Typical High $154.88 | Professional | 52 · Reduced service | $134.90 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $61.66 | Professional | 53 · Discontinued | $53.70 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $46.77 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $30.90 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $30.90 |
Where New York sits
The same service costs 4.1 times more in Wisconsin than in New York. 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· 51st of 51
$245
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.