How much rates vary
Facilitymedian $2,570 · 10th to 90th $66 to $5,012Professionalmedian $35 · 10th to 90th $20 to $72
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 $27.54 Median $2,951.21 Typical High $7,762.47 | Facility | None | $27.54 | $2,951.21 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $36.31 Typical High $66.07 | Professional | None | $19.95 | $36.31 | $66.07 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
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 $27.54 Median $34.67 Typical High $77.62 | Professional | None | $27.54 | $34.67 | $77.62 |
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 $33.88 Median $33.88 Typical High $63.10 | Professional | None | $33.88 | $33.88 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $100.00 Typical High $1,096.48 | Facility | None | $38.90 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $14.13 Median $30.90 Typical High $74.13 | Professional | None | $14.13 | $30.90 | $74.13 |
Emblem Health Setting Facility Modifier None Typical Low $22.91 Median $34.67 Typical High $87.10 | Facility | None | $22.91 | $34.67 | $87.10 |
Emblem Health Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $100.00 | Professional | None | $48.98 | $53.70 | $100.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $30.20 Median $37.15 Typical High $54.95 | Professional | None | $30.20 | $37.15 | $54.95 |
Highmark BCBS Setting Facility Modifier None Typical Low $34.67 Median $83.18 Typical High $831.76 | Facility | None | $34.67 | $83.18 | $831.76 |
MVP Health Care Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
MVP Health Care Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $87.10 | Professional | None | $41.69 | $41.69 | $87.10 |
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 $15.49 Median $31.62 Typical High $63.10 | Professional | None | $15.49 | $31.62 | $63.10 |
Univera Setting Facility Modifier None Typical Low $17.78 Median $38.90 Typical High $117.49 | Facility | None | $17.78 | $38.90 | $117.49 |
Univera Setting Professional Modifier None Typical Low $30.20 Median $38.90 Typical High $54.95 | Professional | None | $30.20 | $38.90 | $54.95 |
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 $10.00 Median $18.20 Typical High $25.12 | Professional | 52 · Reduced service | $10.00 | $18.20 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $7.24 Typical High $10.00 | Professional | 53 · Discontinued | $3.98 | $7.24 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $27.54 Typical High $38.02 | Professional | 54 · Surgery only | $14.79 | $27.54 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $5.50 Typical High $7.59 | Professional | 55 · Aftercare only | $2.95 | $5.50 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $3.63 Typical High $5.01 | Professional | 56 · Pre-op care only | $2.00 | $3.63 | $5.01 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $27.54 Typical High $33.11 | Professional | 53 · Discontinued | $23.44 | $27.54 | $33.11 |
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· 50th of 51
$35.48
AK $120NJ $34.67
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.