How much rates vary
Facilitymedian $3,548 · 10th to 90th $275 to $9,333Professionalmedian $35 · 10th to 90th $15 to $63
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 $645.65 Median $5,888.44 Typical High $10,964.78 | Facility | None | $645.65 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $28.18 Typical High $41.69 | Professional | None | $14.79 | $28.18 | $41.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $38.90 Typical High $66.07 | Professional | None | $31.62 | $38.90 | $66.07 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $51.29 | Professional | None | $24.55 | $24.55 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $1,445.44 Typical High $1,949.84 | Facility | None | $25.70 | $1,445.44 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $21.38 Typical High $66.07 | Professional | None | $10.00 | $21.38 | $66.07 |
Emblem Health Setting Facility Modifier None Typical Low $15.85 Median $22.91 Typical High $58.88 | Facility | None | $15.85 | $22.91 | $58.88 |
Emblem Health Setting Professional Modifier None Typical Low $33.88 Median $37.15 Typical High $63.10 | Professional | None | $33.88 | $37.15 | $63.10 |
Excellus BCBS Setting Professional Modifier None Typical Low $20.42 Median $30.20 Typical High $44.67 | Professional | None | $20.42 | $30.20 | $44.67 |
MVP Health Care Setting Facility Modifier None Typical Low $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
MVP Health Care Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $66.07 | Professional | None | $33.88 | $33.88 | $66.07 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $10.72 Median $23.44 Typical High $56.23 | Professional | None | $10.72 | $23.44 | $56.23 |
Univera Setting Facility Modifier None Typical Low $12.59 Median $31.62 Typical High $95.50 | Facility | None | $12.59 | $31.62 | $95.50 |
Univera Setting Professional Modifier None Typical Low $20.42 Median $30.20 Typical High $44.67 | Professional | None | $20.42 | $30.20 | $44.67 |
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 $7.41 Median $14.13 Typical High $20.89 | Professional | 52 · Reduced service | $7.41 | $14.13 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.95 Median $5.62 Typical High $8.32 | Professional | 53 · Discontinued | $2.95 | $5.62 | $8.32 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.96 Median $21.38 Typical High $31.62 | Professional | 54 · Surgery only | $10.96 | $21.38 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $4.27 Typical High $6.31 | Professional | 55 · Aftercare only | $2.19 | $4.27 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.48 Median $2.82 Typical High $4.17 | Professional | 56 · Pre-op care only | $1.48 | $2.82 | $4.17 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $24.55 Typical High $29.51 | Professional | 53 · Discontinued | $20.89 | $24.55 | $29.51 |
Where New York sits
The same service costs 3.9 times more in Alaska than in Hawaii. 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· 22nd of 51
$37.15
AK $85.11HI $21.88
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.