How much rates vary
Facilitymedian $2,630 · 10th to 90th $91 to $5,012Professionalmedian $25 · 10th to 90th $12 to $52
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 $26.30 Median $3,467.37 Typical High $7,762.47 | Facility | None | $26.30 | $3,467.37 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $26.30 Typical High $43.65 | Professional | None | $11.75 | $26.30 | $43.65 |
Ambetter Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
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 $21.88 Median $26.30 Typical High $54.95 | Professional | None | $21.88 | $26.30 | $54.95 |
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 $20.89 Median $20.89 Typical High $46.77 | Professional | None | $20.89 | $20.89 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $100.00 Typical High $1,096.48 | Facility | None | $22.91 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $9.12 Median $20.42 Typical High $53.70 | Professional | None | $9.12 | $20.42 | $53.70 |
Emblem Health Setting Facility Modifier None Typical Low $14.45 Median $32.36 Typical High $56.23 | Facility | None | $14.45 | $32.36 | $56.23 |
Emblem Health Setting Professional Modifier None Typical Low $35.48 Median $38.90 Typical High $66.07 | Professional | None | $35.48 | $38.90 | $66.07 |
Excellus BCBS Setting Professional Modifier None Typical Low $22.39 Median $29.51 Typical High $38.02 | Professional | None | $22.39 | $29.51 | $38.02 |
Highmark BCBS Setting Facility Modifier None Typical Low $28.84 Median $72.44 Typical High $794.33 | Facility | None | $28.84 | $72.44 | $794.33 |
MVP Health Care Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
MVP Health Care Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $58.88 | Professional | None | $25.12 | $25.12 | $58.88 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,148.15 Typical High $4,365.16 | Facility | None | $309.03 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $9.12 Median $20.42 Typical High $45.71 | Professional | None | $9.12 | $20.42 | $45.71 |
Univera Setting Facility Modifier None Typical Low $10.72 Median $29.51 Typical High $69.18 | Facility | None | $10.72 | $29.51 | $69.18 |
Univera Setting Professional Modifier None Typical Low $22.39 Median $29.51 Typical High $38.02 | Professional | None | $22.39 | $29.51 | $38.02 |
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 $5.89 Median $13.18 Typical High $18.62 | Professional | 52 · Reduced service | $5.89 | $13.18 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $5.25 Typical High $7.41 | Professional | 53 · Discontinued | $2.34 | $5.25 | $7.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.71 Median $19.50 Typical High $27.54 | Professional | 54 · Surgery only | $8.71 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $3.89 Typical High $5.62 | Professional | 55 · Aftercare only | $1.78 | $3.89 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $2.63 Typical High $3.72 | Professional | 56 · Pre-op care only | $1.17 | $2.63 | $3.72 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $19.95 Typical High $23.99 | Professional | 53 · Discontinued | $16.98 | $19.95 | $23.99 |
Where New York sits
The same service costs 3.5 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· 49th of 51
$26.30
AK $83.18NJ $23.99
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.