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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $1,659.59 Typical High $1,659.59 | Professional | None | $707.95 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $190.55 Typical High $380.19 | Facility | None | $138.04 | $190.55 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Emblem Health Setting Facility Modifier None Typical Low $151.36 Median $537.03 Typical High $1,584.89 | Facility | None | $151.36 | $537.03 | $1,584.89 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $1,318.26 Typical High $1,318.26 | Professional | None | $263.03 | $1,318.26 | $1,318.26 |
Excellus BCBS Setting Facility Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,047.13 | Facility | None | $831.76 | $1,047.13 | $1,047.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,047.13 | Professional | None | $831.76 | $831.76 | $1,047.13 |
MVP Health Care Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,818.38 | Facility | None | $2,089.30 | $2,089.30 | $2,818.38 |
MVP Health Care Setting Professional Modifier None Typical Low $338.84 Median $2,089.30 Typical High $2,089.30 | Professional | None | $338.84 | $2,089.30 | $2,089.30 |
United Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Univera Setting Facility Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,047.13 | Facility | None | $831.76 | $1,047.13 | $1,047.13 |
Univera Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,047.13 | Professional | None | $831.76 | $831.76 | $1,047.13 |
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 $812.83 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $165.96 |
Where New York sits
The same service costs 15.1 times more in Arkansas than in North 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· 22nd of 51
$1,047
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.