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 $6,309.57 Typical High $12,589.25 | Facility | None | $1,819.70 | $6,309.57 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $645.65 | Professional | None | $169.82 | $169.82 | $645.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $338.84 | Professional | None | $158.49 | $190.55 | $338.84 |
CDPHP Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $1,862.09 Typical High $45,708.82 | Facility | None | $275.42 | $1,862.09 | $45,708.82 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $213.80 Typical High $588.84 | Professional | None | $199.53 | $213.80 | $588.84 |
Emblem Health Setting Facility Modifier None Typical Low $199.53 Median $251.19 Typical High $645.65 | Facility | None | $199.53 | $251.19 | $645.65 |
Emblem Health Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $363.08 | Professional | None | $181.97 | $208.93 | $363.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $257.04 | Professional | None | $131.83 | $158.49 | $257.04 |
MVP Health Care Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
MVP Health Care Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $467.74 | Professional | None | $251.19 | $251.19 | $467.74 |
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 $138.04 Median $223.87 Typical High $489.78 | Professional | None | $138.04 | $223.87 | $489.78 |
Univera Setting Facility Modifier None Typical Low $173.78 Median $177.83 Typical High $891.25 | Facility | None | $173.78 | $177.83 | $891.25 |
Univera Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $257.04 | Professional | None | $131.83 | $173.78 | $257.04 |
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 $85.11 Median $85.11 Typical High $109.65 | Professional | 52 · Reduced service | $85.11 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $43.65 | Professional | 53 · Discontinued | $33.88 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $162.18 | Professional | 54 · Surgery only | $128.82 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $32.36 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $21.88 |
Where New York sits
The same service costs 3.8 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
$195
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.