How much rates vary
Facilitymedian $2,570 · 10th to 90th $347 to $4,898Professionalmedian $282 · 10th to 90th $182 to $457
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 $758.58 Median $5,888.44 Typical High $10,964.78 | Facility | None | $758.58 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $245.47 Typical High $323.59 | Professional | None | $162.18 | $245.47 | $323.59 |
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 $245.47 Median $288.40 Typical High $389.05 | Professional | None | $245.47 | $288.40 | $389.05 |
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 $263.03 Median $263.03 Typical High $436.52 | Professional | None | $263.03 | $263.03 | $436.52 |
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 $181.97 Median $302.00 Typical High $691.83 | Professional | None | $181.97 | $302.00 | $691.83 |
Emblem Health Setting Facility Modifier None Typical Low $128.82 Median $213.80 Typical High $691.83 | Facility | None | $128.82 | $213.80 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $660.69 | Professional | None | $281.84 | $436.52 | $660.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $426.58 | Professional | None | $186.21 | $323.59 | $426.58 |
MVP Health Care Setting Facility Modifier None Typical Low $194.98 Median $3,235.94 Typical High $4,365.16 | Facility | None | $194.98 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $724.44 | Professional | None | $288.40 | $288.40 | $724.44 |
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 $154.88 Median $269.15 Typical High $549.54 | Professional | None | $154.88 | $269.15 | $549.54 |
Univera Setting Facility Modifier None Typical Low $125.89 Median $281.84 Typical High $776.25 | Facility | None | $125.89 | $281.84 | $776.25 |
Univera Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $426.58 | Professional | None | $218.78 | $295.12 | $426.58 |
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 $79.43 Median $123.03 Typical High $147.91 | Professional | 52 · Reduced service | $79.43 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $48.98 Typical High $58.88 | Professional | 53 · Discontinued | $32.36 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $186.21 Typical High $223.87 | Professional | 54 · Surgery only | $120.23 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $37.15 Typical High $44.67 | Professional | 55 · Aftercare only | $23.99 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $24.55 Typical High $29.51 | Professional | 56 · Pre-op care only | $15.85 | $24.55 | $29.51 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $162.18 Typical High $234.42 | Professional | 53 · Discontinued | $158.49 | $162.18 | $234.42 |
Where New York sits
The same service costs 3.8 times more in Alaska than in Maryland. 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· 29th of 51
$288
AK $759MD $200
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.