How much rates vary
Facilitymedian $2,570 · 10th to 90th $126 to $5,012Professionalmedian $117 · 10th to 90th $60 to $209
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 $93.33 Median $3,801.89 Typical High $8,128.31 | Facility | None | $93.33 | $3,801.89 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $97.72 Typical High $173.78 | Professional | None | $56.23 | $97.72 | $173.78 |
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 $109.65 Median $131.83 Typical High $199.53 | Professional | None | $109.65 | $131.83 | $199.53 |
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 $77.62 Median $77.62 Typical High $144.54 | Professional | None | $77.62 | $77.62 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $109.65 Typical High $245.47 | Facility | None | $83.18 | $109.65 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $83.18 Typical High $346.74 | Professional | None | $41.69 | $83.18 | $346.74 |
Emblem Health Setting Facility Modifier None Typical Low $53.70 Median $72.44 Typical High $190.55 | Facility | None | $53.70 | $72.44 | $190.55 |
Emblem Health Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $218.78 | Professional | None | $109.65 | $125.89 | $218.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $125.89 | Professional | None | $67.61 | $95.50 | $125.89 |
Highmark BCBS Setting Facility Modifier None Typical Low $64.57 Median $457.09 Typical High $1,288.25 | Facility | None | $64.57 | $457.09 | $1,288.25 |
MVP Health Care Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
MVP Health Care Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $263.03 | Professional | None | $85.11 | $85.11 | $263.03 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,174.90 Typical High $4,365.16 | Facility | None | $363.08 | $1,174.90 | $4,365.16 |
United Setting Professional Modifier None Typical Low $38.02 Median $81.28 Typical High $239.88 | Professional | None | $38.02 | $81.28 | $239.88 |
Univera Setting Facility Modifier None Typical Low $40.74 Median $91.20 Typical High $263.03 | Facility | None | $40.74 | $91.20 | $263.03 |
Univera Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $117.49 | Professional | None | $67.61 | $95.50 | $117.49 |
6 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 $28.18 Median $46.77 Typical High $52.48 | Professional | 52 · Reduced service | $28.18 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $18.62 Typical High $20.89 | Professional | 53 · Discontinued | $11.22 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $69.18 Typical High $79.43 | Professional | 54 · Surgery only | $41.69 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $13.80 Typical High $15.85 | Professional | 55 · Aftercare only | $8.32 | $13.80 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $9.33 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.62 | $9.33 | $10.47 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $66.07 Typical High $104.71 | Professional | 53 · Discontinued | $48.98 | $66.07 | $104.71 |
Where New York sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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
$120
AK $257PA $93.33
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.