How much rates vary
Facilitymedian $2,630 · 10th to 90th $209 to $5,129Professionalmedian $117 · 10th to 90th $79 to $234
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 $120.23 Median $3,548.13 Typical High $7,762.47 | Facility | None | $120.23 | $3,548.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $229.09 | Professional | None | $79.43 | $120.23 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $288.40 | Professional | None | $151.36 | $151.36 | $288.40 |
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 $97.72 Median $117.49 Typical High $251.19 | Professional | None | $97.72 | $117.49 | $251.19 |
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 $131.83 Median $131.83 Typical High $204.17 | Professional | None | $131.83 | $131.83 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $204.17 Typical High $1,479.11 | Facility | None | $109.65 | $204.17 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $120.23 Typical High $245.47 | Professional | None | $60.26 | $120.23 | $245.47 |
Emblem Health Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $309.03 | Facility | None | $75.86 | $100.00 | $309.03 |
Emblem Health Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $302.00 | Professional | None | $158.49 | $173.78 | $302.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $173.78 | Professional | None | $97.72 | $117.49 | $173.78 |
Highmark BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
MVP Health Care Setting Facility Modifier None Typical Low $123.03 Median $3,235.94 Typical High $4,365.16 | Facility | None | $123.03 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $316.23 | Professional | None | $147.91 | $147.91 | $316.23 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $4,897.79 | Facility | None | $549.54 | $1,737.80 | $4,897.79 |
United Setting Professional Modifier None Typical Low $60.26 Median $109.65 Typical High $213.80 | Professional | None | $60.26 | $109.65 | $213.80 |
Univera Setting Facility Modifier None Typical Low $67.61 Median $131.83 Typical High $316.23 | Facility | None | $67.61 | $131.83 | $316.23 |
Univera Setting Professional Modifier None Typical Low $97.72 Median $117.49 Typical High $173.78 | Professional | None | $97.72 | $117.49 | $173.78 |
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 $39.81 Median $60.26 Typical High $66.07 | Professional | 52 · Reduced service | $39.81 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $23.99 Typical High $26.30 | Professional | 53 · Discontinued | $15.85 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $91.20 Typical High $97.72 | Professional | 54 · Surgery only | $60.26 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $18.20 Typical High $19.50 | Professional | 55 · Aftercare only | $12.02 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $12.02 Typical High $13.18 | Professional | 56 · Pre-op care only | $7.94 | $12.02 | $13.18 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $91.20 Typical High $109.65 | Professional | 53 · Discontinued | $74.13 | $91.20 | $109.65 |
Where New York sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 48th of 51
$123
AK $372FL $117
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.