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 $4,073.80 Median $5,370.32 Typical High $11,748.98 | Facility | None | $4,073.80 | $5,370.32 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,677.35 | Professional | None | $4,073.80 | $4,073.80 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $6,760.83 | Professional | None | $4,897.79 | $4,897.79 | $6,760.83 |
CDPHP Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
Cigna Setting Facility Modifier None Typical Low $5,011.87 Median $5,128.61 Typical High $7,413.10 | Facility | None | $5,011.87 | $5,128.61 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Emblem Health Setting Facility Modifier None Typical Low $4,897.79 Median $6,309.57 Typical High $12,589.25 | Facility | None | $4,897.79 | $6,309.57 | $12,589.25 |
Emblem Health Setting Professional Modifier None Typical Low $5,623.41 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,623.41 | $5,888.44 | $5,888.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
MVP Health Care Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,715.35 | Professional | None | $3,630.78 | $3,630.78 | $3,715.35 |
United Setting Professional Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $6,456.54 | Professional | None | $4,897.79 | $5,128.61 | $6,456.54 |
Univera Setting Facility Modifier None Typical Low $1,584.89 Median $3,311.31 Typical High $3,311.31 | Facility | None | $1,584.89 | $3,311.31 | $3,311.31 |
Univera Setting Professional Modifier None Typical Low $891.25 Median $3,162.28 Typical High $3,162.28 | Professional | None | $891.25 | $3,162.28 | $3,162.28 |
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 $1,995.26 Median $1,995.26 Typical High $2,344.23 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $812.83 Typical High $933.25 | Professional | 53 · Discontinued | $812.83 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $707.95 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $407.38 Typical High $467.74 | Professional | 56 · Pre-op care only | $407.38 | $407.38 | $467.74 |
Where New York sits
The same service costs 1.8 times more in Alaska than in North Carolina. 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· 17th of 51
$5,012
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.