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 $3,715.35 Median $4,466.84 Typical High $6,456.54 | Facility | None | $3,715.35 | $4,466.84 | $6,456.54 |
Aetna Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $6,456.54 | Professional | None | $4,466.84 | $4,466.84 | $6,456.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $20,892.96 | Facility | None | $10,471.29 | $10,471.29 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $18,197.01 | Professional | None | $5,623.41 | $5,623.41 | $18,197.01 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $562.34 Median $562.34 Typical High $1,230.27 | Professional | RR · Rental | $562.34 | $562.34 | $1,230.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,265.80 Median $4,265.80 Typical High $7,585.78 | Professional | UE · Used equipment | $4,265.80 | $4,265.80 | $7,585.78 |
CDPHP Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $8,511.38 | Professional | None | $8,511.38 | $8,511.38 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $7,079.46 | Facility | None | $6,606.93 | $6,606.93 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Emblem Health Setting Facility Modifier None Typical Low $10,471.29 Median $16,982.44 Typical High $37,153.52 | Facility | None | $10,471.29 | $16,982.44 | $37,153.52 |
Emblem Health Setting Professional Modifier None Typical Low $6,760.83 Median $10,964.78 Typical High $18,197.01 | Professional | None | $6,760.83 | $10,964.78 | $18,197.01 |
Excellus BCBS Setting Professional Modifier None Typical Low $5,754.40 Median $6,456.54 Typical High $8,511.38 | Professional | None | $5,754.40 | $6,456.54 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $15,135.61 | Professional | None | $6,309.57 | $6,309.57 | $15,135.61 |
United Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $16,218.10 | Facility | None | $12,589.25 | $12,589.25 | $16,218.10 |
United Setting Professional Modifier None Typical Low $3,388.44 Median $6,165.95 Typical High $7,079.46 | Professional | None | $3,388.44 | $6,165.95 | $7,079.46 |
Univera Setting Facility Modifier None Typical Low $5,495.41 Median $6,165.95 Typical High $6,165.95 | Facility | None | $5,495.41 | $6,165.95 | $6,165.95 |
Univera Setting Professional Modifier None Typical Low $5,754.40 Median $6,456.54 Typical High $8,511.38 | Professional | None | $5,754.40 | $6,456.54 | $8,511.38 |
2 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 55 · Aftercare only Typical Low $660.69 Median $660.69 Typical High $954.99 | Professional | 55 · Aftercare only | $660.69 | $660.69 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $446.68 Typical High $645.65 | Professional | 56 · Pre-op care only | $446.68 | $446.68 | $645.65 |
Where New York sits
The same service costs 2.3 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· 30th of 51
$6,166
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.