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 $1,288.25 Median $1,548.82 Typical High $2,238.72 | Facility | None | $1,288.25 | $1,548.82 | $2,238.72 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,548.82 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $3,715.35 Typical High $7,244.36 | Facility | None | $3,630.78 | $3,715.35 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $6,309.57 | Professional | None | $1,995.26 | $1,995.26 | $6,309.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $199.53 Median $199.53 Typical High $436.52 | Professional | RR · Rental | $199.53 | $199.53 | $436.52 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,479.11 Median $1,479.11 Typical High $2,691.53 | Professional | UE · Used equipment | $1,479.11 | $1,479.11 | $2,691.53 |
CDPHP Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,754.23 | Facility | None | $2,454.71 | $2,454.71 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Emblem Health Setting Facility Modifier None Typical Low $3,630.78 Median $6,025.60 Typical High $13,182.57 | Facility | None | $3,630.78 | $6,025.60 | $13,182.57 |
Emblem Health Setting Professional Modifier None Typical Low $2,344.23 Median $3,801.89 Typical High $6,456.54 | Professional | None | $2,344.23 | $3,801.89 | $6,456.54 |
Excellus BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,137.96 Median $2,238.72 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,238.72 | $2,951.21 |
MVP Health Care Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Facility | None | $4,897.79 | $4,897.79 | $4,897.79 |
MVP Health Care Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $5,248.07 | Professional | None | $2,089.30 | $2,089.30 | $5,248.07 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $2,290.87 Typical High $5,370.32 | Facility | None | $2,187.76 | $2,290.87 | $5,370.32 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,174.90 | $2,187.76 | $2,570.40 |
Univera Setting Facility Modifier None Typical Low $2,137.96 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,137.96 | $2,238.72 | $2,238.72 |
Univera Setting Professional Modifier None Typical Low $2,137.96 Median $2,238.72 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,238.72 | $2,951.21 |
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 $776.25 Median $776.25 Typical High $1,122.02 | Professional | 52 · Reduced service | $776.25 | $776.25 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $446.68 | Professional | 53 · Discontinued | $309.03 | $309.03 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $338.84 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $223.87 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $223.87 |
Where New York sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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
$2,138
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.