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 $7,413.10 Typical High $40,738.03 | Facility | None | $1,819.70 | $7,413.10 | $40,738.03 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $12,882.50 Typical High $52,480.75 | Facility | None | $1,819.70 | $12,882.50 | $52,480.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.88 Median $3.39 Typical High $3.98 | Professional | None | $2.88 | $3.39 | $3.98 |
CDPHP Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $15,135.61 | Facility | None | $5,011.87 | $5,011.87 | $15,135.61 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $25,118.86 Typical High $48,977.88 | Facility | None | $1,862.09 | $25,118.86 | $48,977.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,445.44 | Facility | None | $1,348.96 | $1,348.96 | $1,445.44 |
MVP Health Care Setting Facility Modifier None Typical Low $15,135.61 Median $23,442.29 Typical High $36,307.81 | Facility | None | $15,135.61 | $23,442.29 | $36,307.81 |
United Setting Facility Modifier None Typical Low $575.44 Median $2,137.96 Typical High $33,113.11 | Facility | None | $575.44 | $2,137.96 | $33,113.11 |
United Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $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 $346.74 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $69.18 |
Where New York sits
The same service costs 6025.6 times more in Oklahoma than in Maine. 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· 15th of 51
$6,310
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.