How much rates vary
Facilitymedian $3,311 · 10th to 90th $295 to $6,166Professionalmedian $132 · 10th to 90th $69 to $288
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 $181.97 Median $3,890.45 Typical High $8,128.31 | Facility | None | $181.97 | $3,890.45 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $158.49 Typical High $204.17 | Professional | None | $69.18 | $158.49 | $204.17 |
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 $112.20 Median $131.83 Typical High $251.19 | Professional | None | $112.20 | $131.83 | $251.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $169.82 Median $199.53 Typical High $354.81 | Professional | 50 · Both sides | $169.82 | $199.53 | $354.81 |
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 $95.50 Median $95.50 Typical High $275.42 | Professional | None | $95.50 | $95.50 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $181.97 Typical High $380.19 | Professional | None | $60.26 | $181.97 | $380.19 |
Emblem Health Setting Facility Modifier None Typical Low $64.57 Median $97.72 Typical High $213.80 | Facility | None | $64.57 | $97.72 | $213.80 |
Emblem Health Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $331.13 | Professional | None | $199.53 | $223.87 | $331.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $257.04 | Professional | None | $125.89 | $177.83 | $257.04 |
MVP Health Care Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
MVP Health Care Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $446.68 | Professional | None | $87.10 | $87.10 | $446.68 |
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 $57.54 Median $151.36 Typical High $309.03 | Professional | None | $57.54 | $151.36 | $309.03 |
Univera Setting Facility Modifier None Typical Low $43.65 Median $87.10 Typical High $346.74 | Facility | None | $43.65 | $87.10 | $346.74 |
Univera Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $257.04 | Professional | None | $125.89 | $177.83 | $257.04 |
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 $34.67 Median $81.28 Typical High $102.33 | Professional | 52 · Reduced service | $34.67 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $32.36 Typical High $40.74 | Professional | 53 · Discontinued | $13.80 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $120.23 Typical High $154.88 | Professional | 54 · Surgery only | $51.29 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $23.99 Typical High $30.90 | Professional | 55 · Aftercare only | $10.23 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $16.22 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.92 | $16.22 | $20.42 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $158.49 Median $181.97 Typical High $186.21 | Professional | GL · Free upgrade | $158.49 | $181.97 | $186.21 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $117.49 Typical High $186.21 | Professional | 53 · Discontinued | $93.33 | $117.49 | $186.21 |
Where New York sits
The same service costs 3.5 times more in North Carolina than in Indiana. 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· 41st of 51
$135
NC $302IN $85.11
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.