How much rates vary
Facilitymedian $3,162 · 10th to 90th $126 to $6,166Professionalmedian $115 · 10th to 90th $51 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 $53.70 Median $2,398.83 Typical High $7,762.47 | Facility | None | $53.70 | $2,398.83 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $131.83 Typical High $194.98 | Professional | None | $51.29 | $131.83 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $234.42 | Professional | None | $117.49 | $138.04 | $234.42 |
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 $97.72 Median $114.82 Typical High $218.78 | Professional | None | $97.72 | $114.82 | $218.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $147.91 Median $173.78 Typical High $309.03 | Professional | 50 · Both sides | $147.91 | $173.78 | $309.03 |
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 $70.79 Median $70.79 Typical High $234.42 | Professional | None | $70.79 | $70.79 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $158.49 Typical High $309.03 | Professional | None | $45.71 | $158.49 | $309.03 |
Emblem Health Setting Facility Modifier None Typical Low $47.86 Median $72.44 Typical High $162.18 | Facility | None | $47.86 | $72.44 | $162.18 |
Emblem Health Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $275.42 | Professional | None | $169.82 | $186.21 | $275.42 |
Excellus BCBS Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $204.17 | Professional | None | $104.71 | $144.54 | $204.17 |
Highmark BCBS Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $2,238.72 | Facility | None | $125.89 | $162.18 | $2,238.72 |
Highmark BCBS Setting Professional Modifier None Typical Low $72.44 Median $120.23 Typical High $229.09 | Professional | None | $72.44 | $120.23 | $229.09 |
MVP Health Care Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
MVP Health Care Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $398.11 | Professional | None | $74.13 | $74.13 | $398.11 |
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 $43.65 Median $125.89 Typical High $263.03 | Professional | None | $43.65 | $125.89 | $263.03 |
Univera Setting Facility Modifier None Typical Low $33.11 Median $64.57 Typical High $263.03 | Facility | None | $33.11 | $64.57 | $263.03 |
Univera Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $204.17 | Professional | None | $104.71 | $151.36 | $204.17 |
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 $25.12 Median $66.07 Typical High $87.10 | Professional | 52 · Reduced service | $25.12 | $66.07 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $26.30 Typical High $34.67 | Professional | 53 · Discontinued | $10.23 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $97.72 Typical High $131.83 | Professional | 54 · Surgery only | $38.02 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $19.50 Typical High $26.30 | Professional | 55 · Aftercare only | $7.59 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $13.18 Typical High $17.38 | Professional | 56 · Pre-op care only | $5.13 | $13.18 | $17.38 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $144.54 Median $169.82 Typical High $169.82 | Professional | GL · Free upgrade | $144.54 | $169.82 | $169.82 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $100.00 Typical High $158.49 | Professional | 53 · Discontinued | $81.28 | $100.00 | $158.49 |
Where New York sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 40th of 51
$117
AK $257VA $66.07
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.