How much rates vary
Facilitymedian $2,399 · 10th to 90th $68 to $5,012Professionalmedian $45 · 10th to 90th $35 to $87
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 $50.12 Median $3,162.28 Typical High $7,762.47 | Facility | None | $50.12 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $54.95 Typical High $70.79 | Professional | None | $38.02 | $54.95 | $70.79 |
Ambetter Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $48.98 | Professional | None | $43.65 | $43.65 | $48.98 |
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 $36.31 Median $42.66 Typical High $69.18 | Professional | None | $36.31 | $42.66 | $69.18 |
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 $53.70 Median $53.70 Typical High $75.86 | Professional | None | $53.70 | $53.70 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $72.44 Typical High $1,479.11 | Facility | None | $38.90 | $72.44 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $51.29 Typical High $112.20 | Professional | None | $35.48 | $51.29 | $112.20 |
Emblem Health Setting Facility Modifier None Typical Low $41.69 Median $56.23 Typical High $147.91 | Facility | None | $41.69 | $56.23 | $147.91 |
Emblem Health Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $93.33 | Professional | None | $48.98 | $61.66 | $93.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $29.51 Median $50.12 Typical High $72.44 | Professional | None | $29.51 | $50.12 | $72.44 |
Highmark BCBS Setting Facility Modifier None Typical Low $218.78 Median $446.68 Typical High $2,570.40 | Facility | None | $218.78 | $446.68 | $2,570.40 |
Highmark BCBS Setting Professional Modifier None Typical Low $48.98 Median $77.62 Typical High $125.89 | Professional | None | $48.98 | $77.62 | $125.89 |
MVP Health Care Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
MVP Health Care Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $138.04 | Professional | None | $52.48 | $52.48 | $138.04 |
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 $30.20 Median $48.98 Typical High $97.72 | Professional | None | $30.20 | $48.98 | $97.72 |
Univera Setting Facility Modifier None Typical Low $23.99 Median $48.98 Typical High $173.78 | Facility | None | $23.99 | $48.98 | $173.78 |
Univera Setting Professional Modifier None Typical Low $34.67 Median $48.98 Typical High $67.61 | Professional | None | $34.67 | $48.98 | $67.61 |
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 $19.05 Median $26.92 Typical High $27.54 | Professional | 52 · Reduced service | $19.05 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $10.72 Typical High $11.22 | Professional | 53 · Discontinued | $7.59 | $10.72 | $11.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $39.81 Typical High $41.69 | Professional | 54 · Surgery only | $28.18 | $39.81 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.94 Typical High $8.32 | Professional | 55 · Aftercare only | $5.75 | $7.94 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.37 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.80 | $5.37 | $5.62 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $29.51 Typical High $41.69 | Professional | 53 · Discontinued | $28.84 | $29.51 | $41.69 |
Where New York sits
The same service costs 4.2 times more in Alaska 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
$44.67
AK $186NY $44.67
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.