How much rates vary
Facilitymedian $2,754 · 10th to 90th $398 to $5,129Professionalmedian $269 · 10th to 90th $79 to $479
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 $1,122.02 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,122.02 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $245.47 Typical High $245.47 | Professional | None | $70.79 | $245.47 | $245.47 |
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 $257.04 Median $309.03 Typical High $478.63 | Professional | None | $257.04 | $309.03 | $478.63 |
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 $114.82 Median $114.82 Typical High $398.11 | Professional | None | $114.82 | $114.82 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,737.80 Typical High $1,862.09 | Facility | None | $676.08 | $1,737.80 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $208.93 Typical High $724.44 | Professional | None | $58.88 | $208.93 | $724.44 |
Emblem Health Setting Facility Modifier None Typical Low $48.98 Median $77.62 Typical High $251.19 | Facility | None | $48.98 | $77.62 | $251.19 |
Emblem Health Setting Professional Modifier None Typical Low $269.15 Median $295.12 Typical High $426.58 | Professional | None | $269.15 | $295.12 | $426.58 |
Excellus BCBS Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $295.12 | Professional | None | $158.49 | $223.87 | $295.12 |
MVP Health Care Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
MVP Health Care Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $602.56 | Professional | None | $251.19 | $251.19 | $602.56 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $53.70 Median $177.83 Typical High $524.81 | Professional | None | $53.70 | $177.83 | $524.81 |
Univera Setting Facility Modifier None Typical Low $52.48 Median $83.18 Typical High $269.15 | Facility | None | $52.48 | $83.18 | $269.15 |
Univera Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $269.15 | Professional | None | $158.49 | $223.87 | $269.15 |
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 $35.48 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $35.48 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $14.13 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $52.48 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $10.47 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $7.08 | $24.55 | $24.55 |
Where New York sits
The same service costs 4.5 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· 13th of 51
$275
OK $575NE $129
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.