How much rates vary
Facilitymedian $3,311 · 10th to 90th $468 to $6,310Professionalmedian $224 · 10th to 90th $83 to $447
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 $389.05 Median $3,981.07 Typical High $8,128.31 | Facility | None | $389.05 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $229.09 Typical High $338.84 | Professional | None | $83.18 | $229.09 | $338.84 |
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 $190.55 Median $223.87 Typical High $398.11 | Professional | None | $190.55 | $223.87 | $398.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $281.84 Median $331.13 Typical High $588.84 | Professional | 50 · Both sides | $281.84 | $331.13 | $588.84 |
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 $117.49 Median $117.49 Typical High $457.09 | Professional | None | $117.49 | $117.49 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $229.09 Typical High $501.19 | Professional | None | $79.43 | $229.09 | $501.19 |
Emblem Health Setting Facility Modifier None Typical Low $81.28 Median $114.82 Typical High $269.15 | Facility | None | $81.28 | $114.82 | $269.15 |
Emblem Health Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $575.44 | Professional | None | $354.81 | $389.05 | $575.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $416.87 | Professional | None | $199.53 | $288.40 | $416.87 |
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 $123.03 Median $123.03 Typical High $741.31 | Professional | None | $123.03 | $123.03 | $741.31 |
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 $74.13 Median $239.88 Typical High $489.78 | Professional | None | $74.13 | $239.88 | $489.78 |
Univera Setting Facility Modifier None Typical Low $53.70 Median $107.15 Typical High $346.74 | Facility | None | $53.70 | $107.15 | $346.74 |
Univera Setting Professional Modifier None Typical Low $199.53 Median $288.40 Typical High $416.87 | Professional | None | $199.53 | $288.40 | $416.87 |
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 $41.69 Median $123.03 Typical High $158.49 | Professional | 52 · Reduced service | $41.69 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $48.98 Typical High $63.10 | Professional | 53 · Discontinued | $16.60 | $48.98 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $181.97 Typical High $234.42 | Professional | 54 · Surgery only | $63.10 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $36.31 Typical High $47.86 | Professional | 55 · Aftercare only | $12.59 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $24.55 Typical High $31.62 | Professional | 56 · Pre-op care only | $8.32 | $24.55 | $31.62 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $229.09 Median $269.15 Typical High $269.15 | Professional | GL · Free upgrade | $229.09 | $269.15 | $269.15 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $190.55 Typical High $302.00 | Professional | 53 · Discontinued | $151.36 | $190.55 | $302.00 |
Where New York sits
The same service costs 4.2 times more in Washington 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· 31st of 51
$224
WA $447VA $107
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.