How much rates vary
Facilitymedian $3,388 · 10th to 90th $708 to $6,457Professionalmedian $141 · 10th to 90th $66 to $240
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 $1,122.02 Median $4,168.69 Typical High $9,772.37 | Facility | None | $1,122.02 | $4,168.69 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $138.04 Typical High $151.36 | Professional | None | $66.07 | $138.04 | $151.36 |
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 $128.82 Median $151.36 Typical High $229.09 | Professional | None | $128.82 | $151.36 | $229.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $229.09 Typical High $316.23 | Professional | 50 · Both sides | $194.98 | $229.09 | $316.23 |
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 $107.15 Median $107.15 Typical High $239.88 | Professional | None | $107.15 | $107.15 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $128.82 Typical High $288.40 | Professional | None | $56.23 | $128.82 | $288.40 |
Emblem Health Setting Facility Modifier None Typical Low $64.57 Median $81.28 Typical High $245.47 | Facility | None | $64.57 | $81.28 | $245.47 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $281.84 | Professional | None | $162.18 | $162.18 | $281.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $194.98 | Professional | None | $109.65 | $144.54 | $194.98 |
MVP Health Care Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
MVP Health Care Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $416.87 | Professional | None | $79.43 | $79.43 | $416.87 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $2,951.21 Typical High $5,011.87 | Facility | None | $1,318.26 | $2,951.21 | $5,011.87 |
United Setting Professional Modifier None Typical Low $44.67 Median $102.33 Typical High $234.42 | Professional | None | $44.67 | $102.33 | $234.42 |
Univera Setting Facility Modifier None Typical Low $54.95 Median $87.10 Typical High $309.03 | Facility | None | $54.95 | $87.10 | $309.03 |
Univera Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $194.98 | Professional | None | $109.65 | $147.91 | $194.98 |
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 $33.11 Median $69.18 Typical High $75.86 | Professional | 52 · Reduced service | $33.11 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $27.54 Typical High $30.20 | Professional | 53 · Discontinued | $13.18 | $27.54 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $102.33 Typical High $114.82 | Professional | 54 · Surgery only | $48.98 | $102.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $20.42 Typical High $22.91 | Professional | 55 · Aftercare only | $10.00 | $20.42 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $13.80 Typical High $15.14 | Professional | 56 · Pre-op care only | $6.61 | $13.80 | $15.14 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $144.54 Median $165.96 Typical High $169.82 | Professional | GL · Free upgrade | $144.54 | $165.96 | $169.82 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $109.65 Typical High $165.96 | Professional | 53 · Discontinued | $89.13 | $109.65 | $165.96 |
Where New York sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 42nd of 51
$141
WI $309UT $120
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.