How much rates vary
Facilitymedian $2,291 · 10th to 90th $263 to $4,467Professionalmedian $204 · 10th to 90th $141 to $339
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 $141.25 Median $208.93 Typical High $524.81 | Facility | None | $141.25 | $208.93 | $524.81 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $229.09 | Professional | None | $144.54 | $208.93 | $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 $173.78 Median $204.17 Typical High $288.40 | Professional | None | $173.78 | $204.17 | $288.40 |
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 $190.55 Median $190.55 Typical High $302.00 | Professional | None | $190.55 | $190.55 | $302.00 |
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 $134.90 Median $213.80 Typical High $501.19 | Professional | None | $134.90 | $213.80 | $501.19 |
Emblem Health Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $512.86 | Facility | None | $100.00 | $162.18 | $512.86 |
Emblem Health Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $467.74 | Professional | None | $199.53 | $309.03 | $467.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $131.83 Median $229.09 Typical High $309.03 | Professional | None | $131.83 | $229.09 | $309.03 |
MVP Health Care Setting Facility Modifier None Typical Low $138.04 Median $3,235.94 Typical High $4,365.16 | Facility | None | $138.04 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $549.54 | Professional | None | $177.83 | $177.83 | $549.54 |
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 $114.82 Median $190.55 Typical High $389.05 | Professional | None | $114.82 | $190.55 | $389.05 |
Univera Setting Facility Modifier None Typical Low $93.33 Median $199.53 Typical High $588.84 | Facility | None | $93.33 | $199.53 | $588.84 |
Univera Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $309.03 | Professional | None | $154.88 | $208.93 | $309.03 |
5 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 $72.44 Median $104.71 Typical High $114.82 | Professional | 52 · Reduced service | $72.44 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $41.69 Typical High $45.71 | Professional | 53 · Discontinued | $28.84 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.90 Typical High $34.67 | Professional | 55 · Aftercare only | $21.38 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $20.89 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.45 | $20.89 | $22.91 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $114.82 Typical High $165.96 | Professional | 53 · Discontinued | $112.20 | $114.82 | $165.96 |
Where New York sits
The same service costs 8.0 times more in New York 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.
Physician feeFacility fee
NY $2,495MD $313
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.