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 $1,122.02 Median $1,318.26 Typical High $1,905.46 | Facility | None | $1,122.02 | $1,318.26 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,905.46 | Professional | None | $1,318.26 | $1,318.26 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $3,162.28 Typical High $6,165.95 | Facility | None | $3,090.30 | $3,162.28 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $5,248.07 | Professional | None | $1,698.24 | $1,737.80 | $5,248.07 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $169.82 Median $169.82 Typical High $371.54 | Professional | RR · Rental | $169.82 | $169.82 | $371.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,258.93 Median $1,258.93 Typical High $2,290.87 | Professional | UE · Used equipment | $1,258.93 | $1,258.93 | $2,290.87 |
CDPHP Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,949.84 | Facility | None | $1,737.80 | $1,737.80 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Emblem Health Setting Facility Modifier None Typical Low $3,090.30 Median $5,128.61 Typical High $11,220.18 | Facility | None | $3,090.30 | $5,128.61 | $11,220.18 |
Emblem Health Setting Professional Modifier None Typical Low $1,995.26 Median $3,235.94 Typical High $5,495.41 | Professional | None | $1,995.26 | $3,235.94 | $5,495.41 |
Excellus BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,659.59 | $1,819.70 | $2,511.89 |
MVP Health Care Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
MVP Health Care Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $4,570.88 | Professional | None | $1,819.70 | $1,819.70 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $4,570.88 | Facility | None | $1,445.44 | $1,621.81 | $4,570.88 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,862.09 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,862.09 | $2,137.96 |
Univera Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,905.46 | Facility | None | $1,659.59 | $1,659.59 | $1,905.46 |
Univera Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,659.59 | $1,819.70 | $2,511.89 |
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 $660.69 Median $660.69 Typical High $954.99 | Professional | 52 · Reduced service | $660.69 | $660.69 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $380.19 | Professional | 53 · Discontinued | $263.03 | $263.03 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $288.40 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $190.55 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $190.55 |
Where New York sits
The same service costs 2.7 times more in Hawaii than in Delaware. 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· 29th of 51
$1,738
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.