How much rates vary
Facilitymedian $2,570 · 10th to 90th $200 to $5,129Professionalmedian $145 · 10th to 90th $52 to $240
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 $131.83 Median $3,715.35 Typical High $7,762.47 | Facility | None | $131.83 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $131.83 Typical High $245.47 | Professional | None | $52.48 | $131.83 | $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 $131.83 Median $165.96 Typical High $257.04 | Professional | None | $131.83 | $165.96 | $257.04 |
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 $81.28 Median $81.28 Typical High $223.87 | Professional | None | $81.28 | $81.28 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $295.12 Typical High $1,778.28 | Facility | None | $154.88 | $295.12 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $100.00 Typical High $251.19 | Professional | None | $34.67 | $100.00 | $251.19 |
Emblem Health Setting Facility Modifier None Typical Low $35.48 Median $56.23 Typical High $177.83 | Facility | None | $35.48 | $56.23 | $177.83 |
Emblem Health Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $338.84 | Professional | None | $165.96 | $181.97 | $338.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $177.83 | Professional | None | $102.33 | $138.04 | $177.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $194.98 Median $794.33 Typical High $1,258.93 | Facility | None | $194.98 | $794.33 | $1,258.93 |
Highmark BCBS Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $295.12 | Professional | None | $165.96 | $165.96 | $295.12 |
MVP Health Care Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
MVP Health Care Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $223.87 | Professional | None | $134.90 | $134.90 | $223.87 |
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 $35.48 Median $91.20 Typical High $213.80 | Professional | None | $35.48 | $91.20 | $213.80 |
Univera Setting Facility Modifier None Typical Low $41.69 Median $74.13 Typical High $177.83 | Facility | None | $41.69 | $74.13 | $177.83 |
Univera Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $177.83 | Professional | None | $102.33 | $138.04 | $177.83 |
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 $26.30 Median $64.57 Typical High $72.44 | Professional | 52 · Reduced service | $26.30 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $26.30 Typical High $28.84 | Professional | 53 · Discontinued | $10.47 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $97.72 Typical High $107.15 | Professional | 54 · Surgery only | $38.90 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $19.50 Typical High $21.38 | Professional | 55 · Aftercare only | $7.76 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $13.18 Typical High $14.45 | Professional | 56 · Pre-op care only | $5.25 | $13.18 | $14.45 |
Where New York sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 24th of 51
$151
AK $282MT $107
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.