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 $1,318.26 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $323.59 Typical High $380.19 | Professional | None | $169.82 | $323.59 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $467.74 | Professional | None | $239.88 | $281.84 | $467.74 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $489.78 | Professional | None | $218.78 | $218.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $281.84 Typical High $660.69 | Professional | None | $120.23 | $281.84 | $660.69 |
Emblem Health Setting Facility Modifier None Typical Low $141.25 Median $177.83 Typical High $512.86 | Facility | None | $141.25 | $177.83 | $512.86 |
Emblem Health Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $602.56 | Professional | None | $354.81 | $398.11 | $602.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $389.05 | Professional | None | $229.09 | $295.12 | $389.05 |
MVP Health Care Setting Facility Modifier None Typical Low $169.82 Median $4,365.16 Typical High $38,018.94 | Facility | None | $169.82 | $4,365.16 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $831.76 | Professional | None | $245.47 | $245.47 | $831.76 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $2,951.21 Typical High $5,011.87 | Facility | None | $1,318.26 | $2,951.21 | $5,011.87 |
United Setting Professional Modifier None Typical Low $144.54 Median $302.00 Typical High $602.56 | Professional | None | $144.54 | $302.00 | $602.56 |
Univera Setting Facility Modifier None Typical Low $128.82 Median $165.96 Typical High $933.25 | Facility | None | $128.82 | $165.96 | $933.25 |
Univera Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $389.05 | Professional | None | $229.09 | $295.12 | $389.05 |
7 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 $85.11 Median $154.88 Typical High $190.55 | Professional | 52 · Reduced service | $85.11 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $61.66 Typical High $75.86 | Professional | 53 · Discontinued | $33.88 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $234.42 Typical High $288.40 | Professional | 54 · Surgery only | $128.82 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $46.77 Typical High $57.54 | Professional | 55 · Aftercare only | $25.70 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $30.90 Typical High $38.02 | Professional | 56 · Pre-op care only | $16.98 | $30.90 | $38.02 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $288.40 Median $331.13 Typical High $331.13 | Professional | GL · Free upgrade | $288.40 | $331.13 | $331.13 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $223.87 Typical High $309.03 | Professional | 53 · Discontinued | $177.83 | $223.87 | $309.03 |
Where New York sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 39th of 51
$282
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.