How much rates vary
Facilitymedian $2,630 · 10th to 90th $229 to $5,012Professionalmedian $78 · 10th to 90th $30 to $148
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 $3,890.45 Typical High $9,772.37 | Facility | None | $93.33 | $3,890.45 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $70.79 Typical High $120.23 | Professional | None | $30.20 | $70.79 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $186.21 | Professional | None | $93.33 | $109.65 | $186.21 |
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 $66.07 Median $83.18 Typical High $165.96 | Professional | None | $66.07 | $83.18 | $165.96 |
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 $47.86 Median $47.86 Typical High $144.54 | Professional | None | $47.86 | $47.86 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $100.00 Typical High $1,096.48 | Facility | None | $48.98 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $64.57 Typical High $151.36 | Professional | None | $20.89 | $64.57 | $151.36 |
Emblem Health Setting Facility Modifier None Typical Low $31.62 Median $39.81 Typical High $114.82 | Facility | None | $31.62 | $39.81 | $114.82 |
Emblem Health Setting Professional Modifier None Typical Low $16.22 Median $51.29 Typical High $97.72 | Professional | None | $16.22 | $51.29 | $97.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $53.70 Median $91.20 Typical High $117.49 | Professional | None | $53.70 | $91.20 | $117.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Highmark BCBS Setting Professional Modifier None Typical Low $64.57 Median $131.83 Typical High $190.55 | Professional | None | $64.57 | $131.83 | $190.55 |
MVP Health Care Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | None | $34.67 | $34.67 | $34.67 |
MVP Health Care Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $162.18 | Professional | None | $37.15 | $37.15 | $162.18 |
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 $20.42 Median $56.23 Typical High $138.04 | Professional | None | $20.42 | $56.23 | $138.04 |
Univera Setting Facility Modifier None Typical Low $25.12 Median $89.13 Typical High $114.82 | Facility | None | $25.12 | $89.13 | $114.82 |
Univera Setting Professional Modifier None Typical Low $53.70 Median $91.20 Typical High $117.49 | Professional | None | $53.70 | $91.20 | $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 $15.14 Median $41.69 Typical High $46.77 | Professional | 52 · Reduced service | $15.14 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $16.60 Typical High $18.62 | Professional | 53 · Discontinued | $6.03 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $61.66 Typical High $70.79 | Professional | 54 · Surgery only | $22.91 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $12.30 Typical High $14.13 | Professional | 55 · Aftercare only | $4.57 | $12.30 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $8.32 Typical High $9.33 | Professional | 56 · Pre-op care only | $3.02 | $8.32 | $9.33 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $61.66 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $61.66 | $74.13 |
Where New York sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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
$81.28
AK $170KY $51.29
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.