How much rates vary
Facilitymedian $3,311 · 10th to 90th $240 to $6,166Professionalmedian $135 · 10th to 90th $76 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 $134.90 Median $3,715.35 Typical High $8,128.31 | Facility | None | $134.90 | $3,715.35 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $162.18 Typical High $213.80 | Professional | None | $75.86 | $162.18 | $213.80 |
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 $114.82 Median $134.90 Typical High $257.04 | Professional | None | $114.82 | $134.90 | $257.04 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $204.17 Typical High $363.08 | Professional | 50 · Both sides | $173.78 | $204.17 | $363.08 |
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 $104.71 Median $104.71 Typical High $281.84 | Professional | None | $104.71 | $104.71 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $190.55 Typical High $389.05 | Professional | None | $66.07 | $190.55 | $389.05 |
Emblem Health Setting Facility Modifier None Typical Low $70.79 Median $107.15 Typical High $234.42 | Facility | None | $70.79 | $107.15 | $234.42 |
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 $158.49 Typical High $245.47 | Professional | None | $125.89 | $158.49 | $245.47 |
Highmark BCBS Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $1,659.59 | Facility | None | $158.49 | $158.49 | $1,659.59 |
Highmark BCBS Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $269.15 | Professional | None | $107.15 | $109.65 | $269.15 |
MVP Health Care Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
MVP Health Care Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $457.09 | Professional | None | $93.33 | $93.33 | $457.09 |
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 $63.10 Median $154.88 Typical High $316.23 | Professional | None | $63.10 | $154.88 | $316.23 |
Univera Setting Facility Modifier None Typical Low $47.86 Median $95.50 Typical High $380.19 | Facility | None | $47.86 | $95.50 | $380.19 |
Univera Setting Professional Modifier None Typical Low $125.89 Median $177.83 Typical High $245.47 | Professional | None | $125.89 | $177.83 | $245.47 |
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 $37.15 Median $81.28 Typical High $107.15 | Professional | 52 · Reduced service | $37.15 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $32.36 Typical High $42.66 | Professional | 53 · Discontinued | $15.14 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $123.03 Typical High $158.49 | Professional | 54 · Surgery only | $56.23 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $24.55 Typical High $31.62 | Professional | 55 · Aftercare only | $11.22 | $24.55 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $16.22 Typical High $21.38 | Professional | 56 · Pre-op care only | $7.59 | $16.22 | $21.38 |
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 $95.50 Median $120.23 Typical High $190.55 | Professional | 53 · Discontinued | $95.50 | $120.23 | $190.55 |
Where New York sits
The same service costs 3.8 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· 45th of 51
$138
AK $363VA $95.50
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.