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 $91.20 Median $104.71 Typical High $120.23 | Facility | None | $91.20 | $104.71 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $120.23 | Professional | None | $104.71 | $120.23 | $120.23 |
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 $154.88 Median $186.21 Typical High $204.17 | Professional | None | $154.88 | $186.21 | $204.17 |
Excellus BCBS Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | None | $128.82 | $141.25 | $141.25 |
United Setting Professional Modifier None Typical Low $15.14 Median $34.67 Typical High $257.04 | Professional | None | $15.14 | $34.67 | $257.04 |
Univera Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $128.82 | Facility | None | $123.03 | $123.03 | $128.82 |
Univera Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | None | $128.82 | $141.25 | $141.25 |
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 $79.43 Median $89.13 Typical High $89.13 | Professional | 54 · Surgery only | $79.43 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $17.78 Typical High $17.78 | Professional | 55 · Aftercare only | $15.85 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.47 | $12.02 | $12.02 |
Where New York sits
The same service costs 16.2 times more in Minnesota 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· 24th of 51
$186
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.