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 $1,513.56 Median $4,365.16 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $165.96 | Professional | None | $56.23 | $56.23 | $165.96 |
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 $36.31 Median $43.65 Typical High $89.13 | Professional | None | $36.31 | $43.65 | $89.13 |
CDPHP Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $100.00 Typical High $1,096.48 | Facility | None | $83.18 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $45.71 Typical High $154.88 | Professional | None | $38.90 | $45.71 | $154.88 |
Emblem Health Setting Facility Modifier None Typical Low $56.23 Median $97.72 Typical High $199.53 | Facility | None | $56.23 | $97.72 | $199.53 |
Emblem Health Setting Professional Modifier None Typical Low $51.29 Median $58.88 Typical High $104.71 | Professional | None | $51.29 | $58.88 | $104.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $30.90 Median $43.65 Typical High $64.57 | Professional | None | $30.90 | $43.65 | $64.57 |
MVP Health Care Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $51.29 | Facility | None | $41.69 | $41.69 | $51.29 |
MVP Health Care Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $123.03 | Professional | None | $74.13 | $74.13 | $123.03 |
United Setting Facility Modifier None Typical Low $338.84 Median $1,148.15 Typical High $4,365.16 | Facility | None | $338.84 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $141.25 | Professional | None | $38.90 | $54.95 | $141.25 |
Univera Setting Facility Modifier None Typical Low $33.11 Median $43.65 Typical High $199.53 | Facility | None | $33.11 | $43.65 | $199.53 |
Univera Setting Professional Modifier None Typical Low $30.90 Median $43.65 Typical High $64.57 | Professional | None | $30.90 | $43.65 | $64.57 |
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 $28.18 Median $28.18 Typical High $31.62 | Professional | 52 · Reduced service | $28.18 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $12.59 | Professional | 53 · Discontinued | $11.22 | $11.22 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $42.66 Typical High $46.77 | Professional | 54 · Surgery only | $42.66 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $9.55 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $6.31 |
Where New York sits
The same service costs 6.5 times more in Tennessee 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
$48.98
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.