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 $33.11 Median $3,548.13 Typical High $9,332.54 | Facility | None | $33.11 | $3,548.13 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $33.11 Typical High $58.88 | Professional | None | $21.38 | $33.11 | $58.88 |
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 $45.71 Median $54.95 Typical High $91.20 | Professional | None | $45.71 | $54.95 | $91.20 |
CDPHP Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $70.79 | Professional | None | $46.77 | $46.77 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $1,778.28 Typical High $3,981.07 | Facility | None | $45.71 | $1,778.28 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Emblem Health Setting Facility Modifier None Typical Low $25.12 Median $33.88 Typical High $104.71 | Facility | None | $25.12 | $33.88 | $104.71 |
Emblem Health Setting Professional Modifier None Typical Low $58.88 Median $64.57 Typical High $102.33 | Professional | None | $58.88 | $64.57 | $102.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $40.74 Median $47.86 Typical High $64.57 | Professional | None | $40.74 | $47.86 | $64.57 |
MVP Health Care Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $104.71 | Professional | None | $48.98 | $48.98 | $104.71 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $26.30 Median $46.77 Typical High $123.03 | Professional | None | $26.30 | $46.77 | $123.03 |
Univera Setting Facility Modifier None Typical Low $30.90 Median $35.48 Typical High $54.95 | Facility | None | $30.90 | $35.48 | $54.95 |
Univera Setting Professional Modifier None Typical Low $34.67 Median $47.86 Typical High $60.26 | Professional | None | $34.67 | $47.86 | $60.26 |
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 $10.47 Median $16.60 Typical High $20.42 | Professional | 52 · Reduced service | $10.47 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $6.61 Typical High $8.13 | Professional | 53 · Discontinued | $4.27 | $6.61 | $8.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.85 Median $25.12 Typical High $30.90 | Professional | 54 · Surgery only | $15.85 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $5.01 Typical High $6.17 | Professional | 55 · Aftercare only | $3.16 | $5.01 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $3.31 Typical High $4.07 | Professional | 56 · Pre-op care only | $2.14 | $3.31 | $4.07 |
Where New York sits
The same service costs 2.8 times more in Alaska than in California. 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· 31st of 51
$52.48
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.