How much rates vary
Facilitymedian $2,570 · 10th to 90th $347 to $4,898Professionalmedian $269 · 10th to 90th $182 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 $707.95 Median $5,888.44 Typical High $10,964.78 | Facility | None | $707.95 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $302.00 | Professional | None | $181.97 | $251.19 | $302.00 |
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 $229.09 Median $269.15 Typical High $363.08 | Professional | None | $229.09 | $269.15 | $363.08 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $407.38 | Professional | None | $251.19 | $251.19 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $263.03 Typical High $524.81 | Facility | None | $100.00 | $263.03 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $281.84 Typical High $660.69 | Professional | None | $173.78 | $281.84 | $660.69 |
Emblem Health Setting Facility Modifier None Typical Low $204.17 Median $251.19 Typical High $707.95 | Facility | None | $204.17 | $251.19 | $707.95 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $602.56 | Professional | None | $263.03 | $407.38 | $602.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $398.11 | Professional | None | $173.78 | $302.00 | $398.11 |
MVP Health Care Setting Facility Modifier None Typical Low $169.82 Median $3,235.94 Typical High $4,365.16 | Facility | None | $169.82 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $660.69 | Professional | None | $269.15 | $269.15 | $660.69 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $512.86 | Professional | None | $151.36 | $251.19 | $512.86 |
Univera Setting Facility Modifier None Typical Low $120.23 Median $263.03 Typical High $794.33 | Facility | None | $120.23 | $263.03 | $794.33 |
Univera Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $398.11 | Professional | None | $204.17 | $275.42 | $398.11 |
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 $91.20 Median $120.23 Typical High $144.54 | Professional | 52 · Reduced service | $91.20 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $47.86 Typical High $57.54 | Professional | 53 · Discontinued | $36.31 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $181.97 Typical High $218.78 | Professional | 54 · Surgery only | $138.04 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $36.31 Typical High $43.65 | Professional | 55 · Aftercare only | $27.54 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $23.99 Typical High $28.84 | Professional | 56 · Pre-op care only | $18.20 | $23.99 | $28.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $151.36 Typical High $218.78 | Professional | 53 · Discontinued | $147.91 | $151.36 | $218.78 |
Where New York sits
The same service costs 4.0 times more in Alaska 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· 34th of 51
$269
AK $741KY $186
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.