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 $63,095.73 Median $75,857.76 Typical High $169,824.37 | Facility | None | $63,095.73 | $75,857.76 | $169,824.37 |
Aetna Setting Professional Modifier None Typical Low $63,095.73 Median $63,095.73 Typical High $74,131.02 | Professional | None | $63,095.73 | $63,095.73 | $74,131.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $69,183.10 Median $75,857.76 Typical High $75,857.76 | Professional | None | $69,183.10 | $75,857.76 | $75,857.76 |
Cigna Setting Facility Modifier None Typical Low $33,884.42 Median $33,884.42 Typical High $117,489.76 | Facility | None | $33,884.42 | $33,884.42 | $117,489.76 |
Cigna Setting Professional Modifier None Typical Low $77,624.71 Median $77,624.71 Typical High $380,189.40 | Professional | None | $77,624.71 | $77,624.71 | $380,189.40 |
Emblem Health Setting Facility Modifier None Typical Low $34,673.69 Median $91,201.08 Typical High $147,910.84 | Facility | None | $34,673.69 | $91,201.08 | $147,910.84 |
Emblem Health Setting Professional Modifier None Typical Low $85,113.80 Median $91,201.08 Typical High $95,499.26 | Professional | None | $85,113.80 | $91,201.08 | $95,499.26 |
Excellus BCBS Setting Facility Modifier None Typical Low $69,183.10 Median $69,183.10 Typical High $70,794.58 | Facility | None | $69,183.10 | $69,183.10 | $70,794.58 |
Excellus BCBS Setting Professional Modifier None Typical Low $69,183.10 Median $69,183.10 Typical High $70,794.58 | Professional | None | $69,183.10 | $69,183.10 | $70,794.58 |
MVP Health Care Setting Facility Modifier None Typical Low $144,543.98 Median $144,543.98 Typical High $144,543.98 | Facility | None | $144,543.98 | $144,543.98 | $144,543.98 |
United Setting Professional Modifier None Typical Low $50,118.72 Median $75,857.76 Typical High $83,176.38 | Professional | None | $50,118.72 | $75,857.76 | $83,176.38 |
Univera Setting Facility Modifier None Typical Low $69,183.10 Median $69,183.10 Typical High $70,794.58 | Facility | None | $69,183.10 | $69,183.10 | $70,794.58 |
Univera Setting Professional Modifier None Typical Low $28,840.32 Median $69,183.10 Typical High $70,794.58 | Professional | None | $28,840.32 | $69,183.10 | $70,794.58 |
4 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 $31,622.78 Median $31,622.78 Typical High $36,307.81 | Professional | 52 · Reduced service | $31,622.78 | $31,622.78 | $36,307.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12,589.25 Median $12,589.25 Typical High $14,791.08 | Professional | 53 · Discontinued | $12,589.25 | $12,589.25 | $14,791.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9,549.93 Median $9,549.93 Typical High $10,964.78 | Professional | 55 · Aftercare only | $9,549.93 | $9,549.93 | $10,964.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6,309.57 Median $6,309.57 Typical High $7,413.10 | Professional | 56 · Pre-op care only | $6,309.57 | $6,309.57 | $7,413.10 |
Where New York sits
The same service costs 3.4 times more in Alaska than in Nebraska. 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
$75,858
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.