How much rates vary
Facilitymedian $2,754 · 10th to 90th $347 to $5,129Professionalmedian $41 · 10th to 90th $32 to $79
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 $1,348.96 Median $4,365.16 Typical High $8,128.31 | Facility | None | $1,348.96 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $85.11 | Professional | None | $40.74 | $40.74 | $85.11 |
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 $33.11 Median $39.81 Typical High $81.28 | Professional | None | $33.11 | $39.81 | $81.28 |
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 $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $100.00 Typical High $1,096.48 | Facility | None | $69.18 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $56.23 Typical High $89.13 | Professional | None | $30.90 | $56.23 | $89.13 |
Emblem Health Setting Facility Modifier None Typical Low $39.81 Median $47.86 Typical High $158.49 | Facility | None | $39.81 | $47.86 | $158.49 |
Emblem Health Setting Professional Modifier None Typical Low $42.66 Median $45.71 Typical High $77.62 | Professional | None | $42.66 | $45.71 | $77.62 |
Excellus BCBS Setting Professional Modifier None Typical Low $30.20 Median $37.15 Typical High $53.70 | Professional | None | $30.20 | $37.15 | $53.70 |
Highmark BCBS Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
MVP Health Care Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
MVP Health Care Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $114.82 | Professional | None | $41.69 | $41.69 | $114.82 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,412.54 Typical High $4,365.16 | Facility | None | $363.08 | $1,412.54 | $4,365.16 |
United Setting Professional Modifier None Typical Low $26.30 Median $44.67 Typical High $81.28 | Professional | None | $26.30 | $44.67 | $81.28 |
Univera Setting Facility Modifier None Typical Low $32.36 Median $42.66 Typical High $177.83 | Facility | None | $32.36 | $42.66 | $177.83 |
Univera Setting Professional Modifier None Typical Low $30.20 Median $38.02 Typical High $53.70 | Professional | None | $30.20 | $38.02 | $53.70 |
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 $20.42 Median $20.42 Typical High $23.99 | Professional | 52 · Reduced service | $20.42 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $9.55 | Professional | 53 · Discontinued | $8.13 | $8.13 | $9.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $30.90 Typical High $35.48 | Professional | 54 · Surgery only | $30.90 | $30.90 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $7.08 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $4.79 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $29.51 Typical High $35.48 | Professional | 53 · Discontinued | $24.55 | $29.51 | $35.48 |
Where New York sits
The same service costs 13.8 times more in Oklahoma 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
$41.69
OK $575NY $41.69
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.