How much rates vary
Facilitymedian $2,630 · 10th to 90th $229 to $5,012Professionalmedian $93 · 10th to 90th $46 to $191
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 $112.20 Median $3,890.45 Typical High $9,772.37 | Facility | None | $112.20 | $3,890.45 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $91.20 Typical High $151.36 | Professional | None | $45.71 | $91.20 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $223.87 | Professional | None | $131.83 | $131.83 | $223.87 |
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 $79.43 Median $97.72 Typical High $199.53 | Professional | None | $79.43 | $97.72 | $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 $72.44 Median $72.44 Typical High $177.83 | Professional | None | $72.44 | $72.44 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $100.00 Typical High $1,096.48 | Facility | None | $74.13 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $77.62 Typical High $186.21 | Professional | None | $30.90 | $77.62 | $186.21 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $52.48 Typical High $162.18 | Facility | None | $34.67 | $52.48 | $162.18 |
Emblem Health Setting Professional Modifier None Typical Low $20.42 Median $85.11 Typical High $125.89 | Professional | None | $20.42 | $85.11 | $125.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $138.04 | Professional | None | $72.44 | $112.20 | $138.04 |
Highmark BCBS Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $676.08 | Facility | None | $660.69 | $660.69 | $676.08 |
Highmark BCBS Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $223.87 | Professional | None | $104.71 | $144.54 | $223.87 |
MVP Health Care Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
MVP Health Care Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $194.98 | Professional | None | $64.57 | $64.57 | $194.98 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $30.90 Median $74.13 Typical High $169.82 | Professional | None | $30.90 | $74.13 | $169.82 |
Univera Setting Facility Modifier None Typical Low $38.02 Median $112.20 Typical High $169.82 | Facility | None | $38.02 | $112.20 | $169.82 |
Univera Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $138.04 | Professional | None | $72.44 | $112.20 | $138.04 |
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 $22.91 Median $51.29 Typical High $56.23 | Professional | 52 · Reduced service | $22.91 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $20.42 Typical High $22.39 | Professional | 53 · Discontinued | $9.33 | $20.42 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $75.86 Typical High $83.18 | Professional | 54 · Surgery only | $34.67 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $15.49 Typical High $16.98 | Professional | 55 · Aftercare only | $6.92 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $10.23 Typical High $11.22 | Professional | 56 · Pre-op care only | $4.57 | $10.23 | $11.22 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $74.13 Typical High $89.13 | Professional | 53 · Discontinued | $63.10 | $74.13 | $89.13 |
Where New York sits
The same service costs 3.5 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· 38th of 51
$95.50
AK $257KY $72.44
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.