How much rates vary
Facilitymedian $2,884 · 10th to 90th $513 to $5,248Professionalmedian $282 · 10th to 90th $162 to $380
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 $4,365.16 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $234.42 | Professional | None | $169.82 | $234.42 | $234.42 |
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 $302.00 Typical High $338.84 | Professional | None | $257.04 | $302.00 | $338.84 |
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 $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
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 $151.36 Median $154.88 Typical High $933.25 | Professional | None | $151.36 | $154.88 | $933.25 |
Emblem Health Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $389.05 Typical High $426.58 | Professional | None | $204.17 | $389.05 | $426.58 |
Excellus BCBS Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $281.84 | Professional | None | $120.23 | $204.17 | $281.84 |
MVP Health Care Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
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 $109.65 Median $186.21 Typical High $501.19 | Professional | None | $109.65 | $186.21 | $501.19 |
Univera Setting Facility Modifier None Typical Low $131.83 Median $204.17 Typical High $208.93 | Facility | None | $131.83 | $204.17 | $208.93 |
Univera Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $281.84 | Professional | None | $120.23 | $204.17 | $281.84 |
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 $85.11 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $85.11 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $33.88 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $177.83 Typical High $177.83 | Professional | 54 · Surgery only | $125.89 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $25.12 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $16.98 | $23.44 | $23.44 |
Where New York sits
The same service costs 7.2 times more in Oklahoma than in Virginia. 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· 27th of 51
$288
OK $1,000VA $138
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.