How much rates vary
Facilitymedian $2,570 · 10th to 90th $234 to $4,898Professionalmedian $145 · 10th to 90th $87 to $295
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 $741.31 Median $4,677.35 Typical High $10,232.93 | Facility | None | $741.31 | $4,677.35 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $158.49 Typical High $218.78 | Professional | None | $87.10 | $158.49 | $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 $123.03 Median $147.91 Typical High $302.00 | Professional | None | $123.03 | $147.91 | $302.00 |
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 $134.90 Median $134.90 Typical High $263.03 | Professional | None | $134.90 | $134.90 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $199.53 Typical High $416.87 | Facility | None | $100.00 | $199.53 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $125.89 Typical High $309.03 | Professional | None | $58.88 | $125.89 | $309.03 |
Emblem Health Setting Facility Modifier None Typical Low $64.57 Median $97.72 Typical High $295.12 | Facility | None | $64.57 | $97.72 | $295.12 |
Emblem Health Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $354.81 | Professional | None | $190.55 | $208.93 | $354.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $208.93 | Professional | None | $120.23 | $165.96 | $208.93 |
Highmark BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
MVP Health Care Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
MVP Health Care Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $323.59 | Professional | None | $114.82 | $114.82 | $323.59 |
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 $57.54 Median $125.89 Typical High $257.04 | Professional | None | $57.54 | $125.89 | $257.04 |
Univera Setting Facility Modifier None Typical Low $70.79 Median $165.96 Typical High $354.81 | Facility | None | $70.79 | $165.96 | $354.81 |
Univera Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $208.93 | Professional | None | $120.23 | $165.96 | $208.93 |
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 $43.65 Median $79.43 Typical High $83.18 | Professional | 52 · Reduced service | $43.65 | $79.43 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $31.62 Typical High $33.11 | Professional | 53 · Discontinued | $17.38 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $120.23 Typical High $125.89 | Professional | 54 · Surgery only | $64.57 | $120.23 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $23.99 Typical High $25.12 | Professional | 55 · Aftercare only | $13.18 | $23.99 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $15.85 Typical High $16.60 | Professional | 56 · Pre-op care only | $8.71 | $15.85 | $16.60 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $114.82 Typical High $138.04 | Professional | 53 · Discontinued | $95.50 | $114.82 | $138.04 |
Where New York sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 42nd of 51
$148
AK $398MD $120
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.