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 $1,513.56 Median $1,778.28 Typical High $1,862.09 | Facility | None | $1,513.56 | $1,778.28 | $1,862.09 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,513.56 | $1,513.56 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $4,168.69 | Professional | None | $1,995.26 | $2,089.30 | $4,168.69 |
CDPHP Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $2,818.38 | Facility | None | $1,862.09 | $2,137.96 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Emblem Health Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $3,019.95 | Facility | None | $1,862.09 | $1,862.09 | $3,019.95 |
Emblem Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,862.09 | $1,862.09 |
Excellus BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $2,344.23 | Facility | None | $1,862.09 | $2,344.23 | $2,344.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,862.09 | $2,344.23 | $2,344.23 |
MVP Health Care Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Facility | None | $3,981.07 | $3,981.07 | $3,981.07 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,884.03 | Professional | None | $2,187.76 | $2,187.76 | $2,884.03 |
Univera Setting Facility Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $2,344.23 | Facility | None | $1,862.09 | $2,344.23 | $2,344.23 |
Univera Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,862.09 | $2,344.23 | $2,344.23 |
5 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 $758.58 Median $758.58 Typical High $870.96 | Professional | 52 · Reduced service | $758.58 | $758.58 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $354.81 | Professional | 53 · Discontinued | $302.00 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $263.03 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $177.83 |
Where New York sits
The same service costs 537.0 times more in Alaska than in Ohio. 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· 14th of 51
$2,089
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.