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 $2,884.03 Median $3,388.44 Typical High $3,548.13 | Facility | None | $2,884.03 | $3,388.44 | $3,548.13 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,884.03 | $2,884.03 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,621.81 | Facility | None | $1,584.89 | $1,584.89 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $3,019.95 Median $3,548.13 Typical High $5,370.32 | Facility | None | $3,019.95 | $3,548.13 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Emblem Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,621.81 | Facility | None | $1,000.00 | $1,000.00 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | None | $851.14 | $1,000.00 | $1,000.00 |
Excellus BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,548.13 | $3,715.35 | $3,715.35 |
Excellus BCBS Setting Professional Modifier None Typical Low $3,548.13 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,548.13 | $3,715.35 | $3,715.35 |
MVP Health Care Setting Facility Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Facility | None | $7,413.10 | $7,413.10 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
United Setting Professional Modifier None Typical Low $3,311.31 Median $3,467.37 Typical High $4,168.69 | Professional | None | $3,311.31 | $3,467.37 | $4,168.69 |
Univera Setting Facility Modifier None Typical Low $3,548.13 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,548.13 | $3,715.35 | $3,715.35 |
Univera Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,715.35 | Professional | None | $3,548.13 | $3,548.13 | $3,715.35 |
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 $1,445.44 Median $1,445.44 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $691.83 | Professional | 53 · Discontinued | $575.44 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $436.52 Typical High $524.81 | Professional | 55 · Aftercare only | $436.52 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $346.74 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $346.74 |
Where New York sits
The same service costs 1.6 times more in North Carolina than in Nebraska. 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· 44th of 51
$3,467
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.