How much rates vary
Facilitymedian $2,754 · 10th to 90th $363 to $5,129Professionalmedian $151 · 10th to 90th $54 to $275
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 $1,122.02 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,122.02 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $165.96 Typical High $229.09 | Professional | None | $53.70 | $165.96 | $229.09 |
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 $128.82 Median $151.36 Typical High $229.09 | Professional | None | $128.82 | $151.36 | $229.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $229.09 Typical High $331.13 | Professional | 50 · Both sides | $194.98 | $229.09 | $331.13 |
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 $74.13 Median $74.13 Typical High $309.03 | Professional | None | $74.13 | $74.13 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $1,778.28 Typical High $1,949.84 | Facility | None | $77.62 | $1,778.28 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $177.83 Typical High $380.19 | Professional | None | $47.86 | $177.83 | $380.19 |
Emblem Health Setting Facility Modifier None Typical Low $51.29 Median $70.79 Typical High $181.97 | Facility | None | $51.29 | $70.79 | $181.97 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $371.54 | Professional | None | $204.17 | $245.47 | $371.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $114.82 Median $194.98 Typical High $263.03 | Professional | None | $114.82 | $194.98 | $263.03 |
MVP Health Care Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
MVP Health Care Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $501.19 | Professional | None | $72.44 | $72.44 | $501.19 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,348.96 Typical High $4,365.16 | Facility | None | $363.08 | $1,348.96 | $4,365.16 |
United Setting Professional Modifier None Typical Low $40.74 Median $128.82 Typical High $302.00 | Professional | None | $40.74 | $128.82 | $302.00 |
Univera Setting Facility Modifier None Typical Low $33.88 Median $194.98 Typical High $263.03 | Facility | None | $33.88 | $194.98 | $263.03 |
Univera Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $263.03 | Professional | None | $131.83 | $194.98 | $263.03 |
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 $26.92 Median $83.18 Typical High $85.11 | Professional | 52 · Reduced service | $26.92 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $33.11 Typical High $33.88 | Professional | 53 · Discontinued | $10.72 | $33.11 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $125.89 Typical High $128.82 | Professional | 54 · Surgery only | $39.81 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $25.12 Typical High $25.70 | Professional | 55 · Aftercare only | $7.94 | $25.12 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $16.60 Typical High $16.98 | Professional | 56 · Pre-op care only | $5.37 | $16.60 | $16.98 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $104.71 Typical High $151.36 | Professional | 53 · Discontinued | $102.33 | $104.71 | $151.36 |
Where New York sits
The same service costs 4.6 times more in Iowa than in Kentucky. 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· 30th of 51
$151
IA $288KY $63.10
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.