How much rates vary
Facilitymedian $2,570 · 10th to 90th $204 to $4,898Professionalmedian $107 · 10th to 90th $58 to $219
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 $57.54 Median $114.82 Typical High $181.97 | Professional | None | $57.54 | $114.82 | $181.97 |
Ambetter Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
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 $93.33 Median $112.20 Typical High $229.09 | Professional | None | $93.33 | $112.20 | $229.09 |
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 $89.13 Median $89.13 Typical High $204.17 | Professional | None | $89.13 | $89.13 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $154.88 Typical High $354.81 | Facility | None | $100.00 | $154.88 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $91.20 Typical High $223.87 | Professional | None | $38.02 | $91.20 | $223.87 |
Emblem Health Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $208.93 | Facility | None | $54.95 | $66.07 | $208.93 |
Emblem Health Setting Professional Modifier None Typical Low $24.55 Median $102.33 Typical High $144.54 | Professional | None | $24.55 | $102.33 | $144.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $158.49 | Professional | None | $87.10 | $125.89 | $158.49 |
Highmark BCBS Setting Professional Modifier None Typical Low $144.54 Median $158.49 Typical High $190.55 | Professional | None | $144.54 | $158.49 | $190.55 |
MVP Health Care Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
MVP Health Care Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $234.42 | Professional | None | $81.28 | $81.28 | $234.42 |
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 $39.81 Median $89.13 Typical High $199.53 | Professional | None | $39.81 | $89.13 | $199.53 |
Univera Setting Facility Modifier None Typical Low $45.71 Median $128.82 Typical High $223.87 | Facility | None | $45.71 | $128.82 | $223.87 |
Univera Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $158.49 | Professional | None | $87.10 | $125.89 | $158.49 |
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 $28.84 Median $61.66 Typical High $64.57 | Professional | 52 · Reduced service | $28.84 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $24.55 Typical High $25.70 | Professional | 53 · Discontinued | $11.48 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $91.20 Typical High $97.72 | Professional | 54 · Surgery only | $42.66 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $18.20 Typical High $19.50 | Professional | 55 · Aftercare only | $8.51 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $12.30 Typical High $12.88 | Professional | 56 · Pre-op care only | $5.75 | $12.30 | $12.88 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $89.13 Typical High $107.15 | Professional | 53 · Discontinued | $74.13 | $89.13 | $107.15 |
Where New York sits
The same service costs 3.1 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
$112
AK $269KY $87.10
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.