How much rates vary
Facilitymedian $3,311 · 10th to 90th $724 to $6,310Professionalmedian $87 · 10th to 90th $69 to $174
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 $1,230.27 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,230.27 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $97.72 Typical High $138.04 | Professional | None | $95.50 | $97.72 | $138.04 |
Ambetter Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,548.13 Typical High $4,897.79 | Facility | None | $1,819.70 | $3,548.13 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $147.91 | Professional | None | $72.44 | $85.11 | $147.91 |
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 $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $79.43 Typical High $263.03 | Professional | None | $69.18 | $79.43 | $263.03 |
Emblem Health Setting Facility Modifier None Typical Low $93.33 Median $112.20 Typical High $363.08 | Facility | None | $93.33 | $112.20 | $363.08 |
Emblem Health Setting Professional Modifier None Typical Low $100.00 Median $109.65 Typical High $162.18 | Professional | None | $100.00 | $109.65 | $162.18 |
Excellus BCBS Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $123.03 | Professional | None | $70.79 | $89.13 | $123.03 |
MVP Health Care Setting Facility Modifier None Typical Low $114.82 Median $3,235.94 Typical High $4,365.16 | Facility | None | $114.82 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $275.42 | Professional | None | $158.49 | $158.49 | $275.42 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $2,818.38 Typical High $4,897.79 | Facility | None | $1,047.13 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $234.42 | Professional | None | $61.66 | $87.10 | $234.42 |
Univera Setting Facility Modifier None Typical Low $77.62 Median $123.03 Typical High $562.34 | Facility | None | $77.62 | $123.03 | $562.34 |
Univera Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $123.03 | Professional | None | $70.79 | $89.13 | $123.03 |
7 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 $47.86 Median $48.98 Typical High $52.48 | Professional | 52 · Reduced service | $47.86 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.50 Typical High $20.89 | Professional | 53 · Discontinued | $19.05 | $19.50 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $72.44 Typical High $79.43 | Professional | 54 · Surgery only | $72.44 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $15.85 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.77 Typical High $10.47 | Professional | 56 · Pre-op care only | $9.55 | $9.77 | $10.47 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $93.33 Median $107.15 Typical High $107.15 | Professional | GL · Free upgrade | $93.33 | $107.15 | $107.15 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $74.13 Typical High $104.71 | Professional | 53 · Discontinued | $57.54 | $74.13 | $104.71 |
Where New York sits
The same service costs 3.5 times more in Wisconsin 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
$89.13
WI $316NY $89.13
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.