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 $1,513.56 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,513.56 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $831.76 | Professional | None | $14.13 | $14.13 | $831.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $7.08 Typical High $23.99 | Professional | 52 · Reduced service | $7.08 | $7.08 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $9.55 | Professional | 53 · Discontinued | $2.82 | $2.82 | $9.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.47 Median $10.47 Typical High $36.31 | Professional | 54 · Surgery only | $10.47 | $10.47 | $36.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $7.24 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $7.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.22 Median $19.05 Typical High $32.36 | Professional | None | $16.22 | $19.05 | $32.36 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $1,949.84 | Facility | None | $1,096.48 | $1,778.28 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Emblem Health Setting Facility Modifier None Typical Low $218.78 Median $263.03 Typical High $426.58 | Facility | None | $218.78 | $263.03 | $426.58 |
Excellus BCBS Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $537.03 | Professional | None | $457.09 | $537.03 | $537.03 |
MVP Health Care Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
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 $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Univera Setting Facility Modifier None Typical Low $436.52 Median $537.03 Typical High $537.03 | Facility | None | $436.52 | $537.03 | $537.03 |
Univera Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $537.03 | Professional | None | $323.59 | $457.09 | $537.03 |
1 more rate 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 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $120.23 | Professional | 56 · Pre-op care only | $4.79 | $4.79 | $120.23 |
Where New York sits
The same service costs 281.8 times more in North Dakota than in Vermont. 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· 40th of 51
$47.86
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.