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 Facility Modifier None Typical Low $354.81 Median $416.87 Typical High $1,122.02 | Facility | None | $354.81 | $416.87 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | None | $354.81 | $389.05 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $44.67 Typical High $50.12 | Professional | None | $38.02 | $44.67 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $537.03 | Professional | None | $489.78 | $489.78 | $537.03 |
United Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $302.00 | Professional | None | $151.36 | $223.87 | $302.00 |
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 $177.83 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $177.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $70.79 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $52.48 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $35.48 | $38.90 | $38.90 |
Where New York sits
The same service costs 38.0 times more in Minnesota than in Connecticut. 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· 50th of 51
$47.86
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.