How much rates vary
Facilitymedian $2,512 · 10th to 90th $141 to $4,898Professionalmedian $71 · 10th to 90th $49 to $117
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 $89.13 Median $5,754.40 Typical High $10,964.78 | Facility | None | $89.13 | $5,754.40 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $75.86 Typical High $79.43 | Professional | None | $51.29 | $75.86 | $79.43 |
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 $61.66 Median $72.44 Typical High $97.72 | Professional | None | $61.66 | $72.44 | $97.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $93.33 Median $109.65 Typical High $147.91 | Professional | 50 · Both sides | $93.33 | $109.65 | $147.91 |
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 $67.61 Median $67.61 Typical High $102.33 | Professional | None | $67.61 | $67.61 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $104.71 Typical High $239.88 | Facility | None | $79.43 | $104.71 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $70.79 Typical High $165.96 | Professional | None | $45.71 | $70.79 | $165.96 |
Emblem Health Setting Facility Modifier None Typical Low $50.12 Median $70.79 Typical High $190.55 | Facility | None | $50.12 | $70.79 | $190.55 |
Emblem Health Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $151.36 | Professional | None | $67.61 | $97.72 | $151.36 |
Excellus BCBS Setting Professional Modifier None Typical Low $45.71 Median $77.62 Typical High $104.71 | Professional | None | $45.71 | $77.62 | $104.71 |
Highmark BCBS Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Facility | None | $288.40 | $288.40 | $288.40 |
MVP Health Care Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
MVP Health Care Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $194.98 | Professional | None | $57.54 | $57.54 | $194.98 |
United Setting Facility Modifier None Typical Low $354.81 Median $1,148.15 Typical High $4,365.16 | Facility | None | $354.81 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $41.69 Median $67.61 Typical High $138.04 | Professional | None | $41.69 | $67.61 | $138.04 |
Univera Setting Facility Modifier None Typical Low $33.11 Median $67.61 Typical High $177.83 | Facility | None | $33.11 | $67.61 | $177.83 |
Univera Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $104.71 | Professional | None | $53.70 | $67.61 | $104.71 |
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 $25.70 Median $35.48 Typical High $39.81 | Professional | 52 · Reduced service | $25.70 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $14.13 Typical High $15.85 | Professional | 53 · Discontinued | $10.47 | $14.13 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $53.70 Typical High $60.26 | Professional | 54 · Surgery only | $38.90 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.72 Typical High $12.02 | Professional | 55 · Aftercare only | $7.76 | $10.72 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.08 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.25 | $7.08 | $7.94 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $40.74 Typical High $58.88 | Professional | 53 · Discontinued | $39.81 | $40.74 | $58.88 |
Where New York sits
The same service costs 3.6 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· 41st of 51
$72.44
AK $204KY $56.23
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.