How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $407.38 | Professional | None | $251.19 | $251.19 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $83.18 | Professional | None | $31.62 | $31.62 | $83.18 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,548.82 | Facility | None | $1,071.52 | $1,258.93 | $1,548.82 |
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 $125.89 Median $125.89 Typical High $204.17 | Professional | 52 · Reduced service | $125.89 | $125.89 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $81.28 | Professional | 53 · Discontinued | $50.12 | $50.12 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $61.66 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $40.74 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $40.74 |
Where New York sits
The same service costs 36.3 times more in New Jersey than in South 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· 39th of 51
$31.62
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.