How much rates vary
Facilitymedian $2,455 · 10th to 90th $76 to $5,012Professionalmedian $46 · 10th to 90th $24 to $89
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 $43.65 Median $3,467.37 Typical High $7,762.47 | Facility | None | $43.65 | $3,467.37 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $45.71 Typical High $79.43 | Professional | None | $23.99 | $45.71 | $79.43 |
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 $38.02 Median $46.77 Typical High $93.33 | Professional | None | $38.02 | $46.77 | $93.33 |
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 $39.81 Median $39.81 Typical High $81.28 | Professional | None | $39.81 | $39.81 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $87.10 Typical High $158.49 | Facility | None | $50.12 | $87.10 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $38.02 Typical High $93.33 | Professional | None | $16.60 | $38.02 | $93.33 |
Emblem Health Setting Facility Modifier None Typical Low $27.54 Median $36.31 Typical High $100.00 | Facility | None | $27.54 | $36.31 | $100.00 |
Emblem Health Setting Professional Modifier None Typical Low $64.57 Median $70.79 Typical High $120.23 | Professional | None | $64.57 | $70.79 | $120.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $69.18 | Professional | None | $39.81 | $52.48 | $69.18 |
MVP Health Care Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
MVP Health Care Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $104.71 | Professional | None | $39.81 | $39.81 | $104.71 |
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 $17.78 Median $38.02 Typical High $77.62 | Professional | None | $17.78 | $38.02 | $77.62 |
Univera Setting Facility Modifier None Typical Low $19.95 Median $52.48 Typical High $131.83 | Facility | None | $19.95 | $52.48 | $131.83 |
Univera Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $69.18 | Professional | None | $39.81 | $52.48 | $69.18 |
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 $12.02 Median $22.91 Typical High $26.30 | Professional | 52 · Reduced service | $12.02 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $9.12 Typical High $10.72 | Professional | 53 · Discontinued | $4.79 | $9.12 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $34.67 Typical High $39.81 | Professional | 54 · Surgery only | $17.78 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $6.92 Typical High $7.94 | Professional | 55 · Aftercare only | $3.63 | $6.92 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $4.57 Typical High $5.37 | Professional | 56 · Pre-op care only | $2.40 | $4.57 | $5.37 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $34.67 Typical High $41.69 | Professional | 53 · Discontinued | $29.51 | $34.67 | $41.69 |
Where New York sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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· 48th of 51
$46.77
AK $138NJ $41.69
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.