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 $22.91 Median $43.65 Typical High $53.70 | Facility | None | $22.91 | $43.65 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $53.70 | Professional | None | $43.65 | $43.65 | $53.70 |
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 $57.54 Median $67.61 Typical High $75.86 | Professional | None | $57.54 | $67.61 | $75.86 |
Excellus BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier None Typical Low $5.01 Median $19.95 Typical High $109.65 | Professional | None | $5.01 | $19.95 | $109.65 |
Univera Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $72.44 | Facility | None | $70.79 | $70.79 | $72.44 |
Univera Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
3 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 54 · Surgery only Typical Low $33.11 Median $33.11 Typical High $40.74 | Professional | 54 · Surgery only | $33.11 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $8.13 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $5.37 |
Where New York sits
The same service costs 123.0 times more in Alabama than in New Jersey. 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· 35th of 51
$67.61
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.