How much rates vary
Facilitymedian $2,754 · 10th to 90th $479 to $5,248Professionalmedian $288 · 10th to 90th $93 to $550
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 $1,096.48 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,096.48 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $245.47 Typical High $281.84 | Professional | None | $79.43 | $245.47 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $537.03 | Professional | None | $263.03 | $316.23 | $537.03 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $436.52 | Professional | None | $128.82 | $128.82 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $691.83 Typical High $1,778.28 | Facility | None | $371.54 | $691.83 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $234.42 Typical High $776.25 | Professional | None | $69.18 | $234.42 | $776.25 |
Emblem Health Setting Facility Modifier None Typical Low $54.95 Median $93.33 Typical High $309.03 | Facility | None | $54.95 | $93.33 | $309.03 |
Emblem Health Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $616.60 | Professional | None | $371.54 | $426.58 | $616.60 |
Excellus BCBS Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $380.19 | Professional | None | $204.17 | $288.40 | $380.19 |
Highmark BCBS 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 |
MVP Health Care Setting Facility Modifier None Typical Low $112.20 Median $3,235.94 Typical High $4,365.16 | Facility | None | $112.20 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $676.08 | Professional | None | $251.19 | $251.19 | $676.08 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $4,897.79 | Facility | None | $549.54 | $1,737.80 | $4,897.79 |
United Setting Professional Modifier None Typical Low $61.66 Median $204.17 Typical High $588.84 | Professional | None | $61.66 | $204.17 | $588.84 |
Univera Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $346.74 | Facility | None | $66.07 | $104.71 | $346.74 |
Univera Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $363.08 | Professional | None | $204.17 | $281.84 | $363.08 |
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 $39.81 Median $123.03 Typical High $138.04 | Professional | 52 · Reduced service | $39.81 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $48.98 Typical High $54.95 | Professional | 53 · Discontinued | $15.85 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $186.21 Typical High $208.93 | Professional | 54 · Surgery only | $60.26 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $37.15 Typical High $41.69 | Professional | 55 · Aftercare only | $12.02 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $24.55 Typical High $27.54 | Professional | 56 · Pre-op care only | $7.94 | $24.55 | $27.54 |
Where New York sits
The same service costs 4.3 times more in Oklahoma 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· 29th of 51
$302
OK $724NE $170
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.