How much rates vary
Facilitymedian $2,455 · 10th to 90th $91 to $5,012Professionalmedian $69 · 10th to 90th $32 to $135
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 $38.02 Median $1,905.46 Typical High $7,585.78 | Facility | None | $38.02 | $1,905.46 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $67.61 Typical High $123.03 | Professional | None | $31.62 | $67.61 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $173.78 | Professional | None | $64.57 | $89.13 | $173.78 |
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 $61.66 Median $74.13 Typical High $147.91 | Professional | None | $61.66 | $74.13 | $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 $51.29 Median $51.29 Typical High $125.89 | Professional | None | $51.29 | $51.29 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $100.00 Typical High $1,096.48 | Facility | None | $61.66 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $57.54 Typical High $144.54 | Professional | None | $23.99 | $57.54 | $144.54 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $43.65 Typical High $141.25 | Facility | None | $34.67 | $43.65 | $141.25 |
Emblem Health Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $186.21 | Professional | None | $91.20 | $91.20 | $186.21 |
Excellus BCBS Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $97.72 | Professional | None | $51.29 | $72.44 | $97.72 |
Highmark BCBS Setting Facility Modifier None Typical Low $630.96 Median $645.65 Typical High $954.99 | Facility | None | $630.96 | $645.65 | $954.99 |
Highmark BCBS Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
MVP Health Care Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
MVP Health Care Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $158.49 | Professional | None | $42.66 | $42.66 | $158.49 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $25.12 Median $54.95 Typical High $120.23 | Professional | None | $25.12 | $54.95 | $120.23 |
Univera Setting Facility Modifier None Typical Low $27.54 Median $83.18 Typical High $128.82 | Facility | None | $27.54 | $83.18 | $128.82 |
Univera Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $97.72 | Professional | None | $51.29 | $72.44 | $97.72 |
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 $15.85 Median $33.88 Typical High $40.74 | Professional | 52 · Reduced service | $15.85 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $13.49 Typical High $16.22 | Professional | 53 · Discontinued | $6.46 | $13.49 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $23.99 Median $51.29 Typical High $61.66 | Professional | 54 · Surgery only | $23.99 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $10.23 Typical High $12.30 | Professional | 55 · Aftercare only | $4.79 | $10.23 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $6.76 Typical High $8.13 | Professional | 56 · Pre-op care only | $3.16 | $6.76 | $8.13 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $53.70 Typical High $64.57 | Professional | 53 · Discontinued | $43.65 | $53.70 | $64.57 |
Where New York sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 36th of 51
$70.79
AK $178KY $47.86
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.