How much rates vary
Facilitymedian $2,570 · 10th to 90th $155 to $4,898Professionalmedian $89 · 10th to 90th $41 to $174
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 $269.15 Median $3,981.07 Typical High $10,232.93 | Facility | None | $269.15 | $3,981.07 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $87.10 Typical High $138.04 | Professional | None | $40.74 | $87.10 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
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 $95.50 Typical High $190.55 | Professional | None | $79.43 | $95.50 | $190.55 |
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 $64.57 Median $64.57 Typical High $165.96 | Professional | None | $64.57 | $64.57 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $144.54 Typical High $323.59 | Facility | None | $100.00 | $144.54 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $74.13 Typical High $177.83 | Professional | None | $28.18 | $74.13 | $177.83 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $45.71 Typical High $141.25 | Facility | None | $34.67 | $45.71 | $141.25 |
Emblem Health Setting Professional Modifier None Typical Low $16.22 Median $70.79 Typical High $120.23 | Professional | None | $16.22 | $70.79 | $120.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $66.07 Median $93.33 Typical High $131.83 | Professional | None | $66.07 | $93.33 | $131.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Highmark BCBS Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $213.80 | Professional | None | $117.49 | $138.04 | $213.80 |
MVP Health Care Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
MVP Health Care Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $186.21 | Professional | None | $64.57 | $64.57 | $186.21 |
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 $27.54 Median $69.18 Typical High $158.49 | Professional | None | $27.54 | $69.18 | $158.49 |
Univera Setting Facility Modifier None Typical Low $33.11 Median $107.15 Typical High $158.49 | Facility | None | $33.11 | $107.15 | $158.49 |
Univera Setting Professional Modifier None Typical Low $66.07 Median $107.15 Typical High $131.83 | Professional | None | $66.07 | $107.15 | $131.83 |
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 $20.42 Median $47.86 Typical High $53.70 | Professional | 52 · Reduced service | $20.42 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $19.50 Typical High $21.38 | Professional | 53 · Discontinued | $8.13 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $72.44 Typical High $79.43 | Professional | 54 · Surgery only | $30.90 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $14.45 Typical High $15.85 | Professional | 55 · Aftercare only | $6.17 | $14.45 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $9.77 Typical High $10.72 | Professional | 56 · Pre-op care only | $4.07 | $9.77 | $10.72 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $70.79 Typical High $85.11 | Professional | 53 · Discontinued | $60.26 | $70.79 | $85.11 |
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· 33rd of 51
$93.33
AK $229KY $66.07
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.