How much rates vary
Facilitymedian $2,754 · 10th to 90th $407 to $5,370Professionalmedian $251 · 10th to 90th $178 to $589
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 $1,659.59 Median $5,623.41 Typical High $9,772.37 | Facility | None | $1,659.59 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $380.19 | Professional | None | $190.55 | $257.04 | $380.19 |
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 $199.53 Median $239.88 Typical High $630.96 | Professional | None | $199.53 | $239.88 | $630.96 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $537.03 | Professional | None | $354.81 | $354.81 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $588.84 Typical High $1,862.09 | Facility | None | $309.03 | $588.84 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $302.00 Typical High $630.96 | Professional | None | $165.96 | $302.00 | $630.96 |
Emblem Health Setting Facility Modifier None Typical Low $181.97 Median $269.15 Typical High $870.96 | Facility | None | $181.97 | $269.15 | $870.96 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $831.76 | Professional | None | $478.63 | $478.63 | $831.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $436.52 | Professional | None | $251.19 | $323.59 | $436.52 |
MVP Health Care Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $588.84 | Professional | None | $158.49 | $158.49 | $588.84 |
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 $165.96 Median $295.12 Typical High $562.34 | Professional | None | $165.96 | $295.12 | $562.34 |
Univera Setting Facility Modifier None Typical Low $186.21 Median $281.84 Typical High $954.99 | Facility | None | $186.21 | $281.84 | $954.99 |
Univera Setting Professional Modifier None Typical Low $251.19 Median $323.59 Typical High $436.52 | Professional | None | $251.19 | $323.59 | $436.52 |
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 $95.50 Median $128.82 Typical High $169.82 | Professional | 52 · Reduced service | $95.50 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $51.29 Typical High $69.18 | Professional | 53 · Discontinued | $38.90 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $194.98 Typical High $257.04 | Professional | 54 · Surgery only | $144.54 | $194.98 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $38.90 Typical High $51.29 | Professional | 55 · Aftercare only | $28.84 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $25.70 Typical High $34.67 | Professional | 56 · Pre-op care only | $19.05 | $25.70 | $34.67 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $234.42 Typical High $281.84 | Professional | 53 · Discontinued | $190.55 | $234.42 | $281.84 |
Where New York sits
The same service costs 4.0 times more in Alaska than in New York. 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· 51st of 51
$257
AK $1,023NY $257
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.