How much rates vary
Facilitymedian $2,692 · 10th to 90th $282 to $5,012Professionalmedian $91 · 10th to 90th $45 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 $645.65 Median $4,168.69 Typical High $10,232.93 | Facility | None | $645.65 | $4,168.69 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $93.33 Typical High $151.36 | Professional | None | $44.67 | $93.33 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
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 $100.00 Typical High $199.53 | Professional | None | $79.43 | $100.00 | $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 $70.79 Median $70.79 Typical High $177.83 | Professional | None | $70.79 | $70.79 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $100.00 Typical High $1,096.48 | Facility | None | $72.44 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $77.62 Typical High $190.55 | Professional | None | $29.51 | $77.62 | $190.55 |
Emblem Health Setting Facility Modifier None Typical Low $44.67 Median $53.70 Typical High $165.96 | Facility | None | $44.67 | $53.70 | $165.96 |
Emblem Health Setting Professional Modifier None Typical Low $20.42 Median $72.44 Typical High $85.11 | Professional | None | $20.42 | $72.44 | $85.11 |
Excellus BCBS Setting Professional Modifier None Typical Low $74.13 Median $97.72 Typical High $141.25 | Professional | None | $74.13 | $97.72 | $141.25 |
Highmark BCBS Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $144.54 | Professional | None | $112.20 | $144.54 | $144.54 |
MVP Health Care Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
MVP Health Care Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $199.53 | Professional | None | $67.61 | $67.61 | $199.53 |
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 $30.20 Median $74.13 Typical High $169.82 | Professional | None | $30.20 | $74.13 | $169.82 |
Univera Setting Facility Modifier None Typical Low $35.48 Median $112.20 Typical High $186.21 | Facility | None | $35.48 | $112.20 | $186.21 |
Univera Setting Professional Modifier None Typical Low $74.13 Median $112.20 Typical High $141.25 | Professional | None | $74.13 | $112.20 | $141.25 |
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 $22.39 Median $51.29 Typical High $56.23 | Professional | 52 · Reduced service | $22.39 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $20.89 Typical High $22.39 | Professional | 53 · Discontinued | $8.91 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $77.62 Typical High $85.11 | Professional | 54 · Surgery only | $33.11 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $15.49 Typical High $16.98 | Professional | 55 · Aftercare only | $6.61 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $10.47 Typical High $11.22 | Professional | 56 · Pre-op care only | $4.47 | $10.47 | $11.22 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $75.86 Typical High $91.20 | Professional | 53 · Discontinued | $63.10 | $75.86 | $91.20 |
Where New York sits
The same service costs 3.4 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· 43rd of 51
$95.50
AK $251NJ $74.13
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.