How much rates vary
Facilitymedian $2,570 · 10th to 90th $224 to $4,898Professionalmedian $120 · 10th to 90th $68 to $240
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 $354.81 Median $3,981.07 Typical High $10,232.93 | Facility | None | $354.81 | $3,981.07 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $204.17 | Professional | None | $67.61 | $131.83 | $204.17 |
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 $104.71 Median $125.89 Typical High $257.04 | Professional | None | $104.71 | $125.89 | $257.04 |
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 $104.71 Median $104.71 Typical High $223.87 | Professional | None | $104.71 | $104.71 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $177.83 Typical High $371.54 | Facility | None | $100.00 | $177.83 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $102.33 Typical High $257.04 | Professional | None | $44.67 | $102.33 | $257.04 |
Emblem Health Setting Facility Modifier None Typical Low $54.95 Median $75.86 Typical High $234.42 | Facility | None | $54.95 | $75.86 | $234.42 |
Emblem Health Setting Professional Modifier None Typical Low $24.55 Median $102.33 Typical High $162.18 | Professional | None | $24.55 | $102.33 | $162.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $177.83 | Professional | None | $95.50 | $141.25 | $177.83 |
Highmark BCBS Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $190.55 | Professional | None | $144.54 | $190.55 | $190.55 |
MVP Health Care Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
MVP Health Care Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $263.03 | Professional | None | $95.50 | $95.50 | $263.03 |
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 $45.71 Median $102.33 Typical High $218.78 | Professional | None | $45.71 | $102.33 | $218.78 |
Univera Setting Facility Modifier None Typical Low $54.95 Median $141.25 Typical High $281.84 | Facility | None | $54.95 | $141.25 | $281.84 |
Univera Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $177.83 | Professional | None | $95.50 | $141.25 | $177.83 |
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 $33.88 Median $69.18 Typical High $70.79 | Professional | 52 · Reduced service | $33.88 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $27.54 Typical High $28.18 | Professional | 53 · Discontinued | $13.49 | $27.54 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $102.33 Typical High $107.15 | Professional | 54 · Surgery only | $51.29 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $20.42 Typical High $21.38 | Professional | 55 · Aftercare only | $10.23 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $13.80 Typical High $14.13 | Professional | 56 · Pre-op care only | $6.76 | $13.80 | $14.13 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $97.72 Typical High $117.49 | Professional | 53 · Discontinued | $81.28 | $97.72 | $117.49 |
Where New York sits
The same service costs 3.2 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· 37th of 51
$126
AK $309KY $97.72
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.