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 $5,248.07 Typical High $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $562.34 | Professional | None | $251.19 | $251.19 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $44.67 Typical High $50.12 | Professional | None | $37.15 | $44.67 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $5,888.44 | Facility | None | $1,445.44 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $524.81 Typical High $2,511.89 | Professional | None | $338.84 | $524.81 | $2,511.89 |
Emblem Health Setting Facility Modifier None Typical Low $691.83 Median $1,122.02 Typical High $2,884.03 | Facility | None | $691.83 | $1,122.02 | $2,884.03 |
Emblem Health Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,288.25 | Professional | None | $758.58 | $831.76 | $1,288.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,047.13 | Professional | None | $467.74 | $616.60 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,943.28 | Facility | None | $1,122.02 | $2,754.23 | $7,943.28 |
United Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $1,862.09 | Professional | None | $512.86 | $676.08 | $1,862.09 |
Univera Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $776.25 | Facility | None | $549.54 | $549.54 | $776.25 |
Univera Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $1,047.13 | Professional | None | $446.68 | $616.60 | $1,047.13 |
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 $125.89 Median $125.89 Typical High $125.89 | Professional | 52 · Reduced service | $125.89 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 53 · Discontinued | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 54 · Surgery only | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $25.12 |
Where New York sits
The same service costs 53.7 times more in Alaska 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
$50.12
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.