How much rates vary
Facilitymedian $1,778 · 10th to 90th $83 to $4,467Professionalmedian $76 · 10th to 90th $44 to $123
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 $42.66 Median $83.18 Typical High $138.04 | Facility | None | $42.66 | $83.18 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $83.18 Typical High $95.50 | Professional | None | $54.95 | $83.18 | $95.50 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
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 $66.07 Median $77.62 Typical High $104.71 | Professional | None | $66.07 | $77.62 | $104.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $97.72 Median $114.82 Typical High $154.88 | Professional | 50 · Both sides | $97.72 | $114.82 | $154.88 |
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 $58.88 Median $58.88 Typical High $114.82 | Professional | None | $58.88 | $58.88 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $114.82 Typical High $257.04 | Facility | None | $81.28 | $114.82 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $77.62 Typical High $181.97 | Professional | None | $40.74 | $77.62 | $181.97 |
Emblem Health Setting Facility Modifier None Typical Low $45.71 Median $60.26 Typical High $154.88 | Facility | None | $45.71 | $60.26 | $154.88 |
Emblem Health Setting Professional Modifier None Typical Low $74.13 Median $117.49 Typical High $173.78 | Professional | None | $74.13 | $117.49 | $173.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $47.86 Median $83.18 Typical High $109.65 | Professional | None | $47.86 | $83.18 | $109.65 |
Highmark BCBS Setting Facility Modifier None Typical Low $102.33 Median $257.04 Typical High $630.96 | Facility | None | $102.33 | $257.04 | $630.96 |
Highmark BCBS Setting Professional Modifier None Typical Low $61.66 Median $112.20 Typical High $199.53 | Professional | None | $61.66 | $112.20 | $199.53 |
MVP Health Care Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
MVP Health Care Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $223.87 | Professional | None | $54.95 | $54.95 | $223.87 |
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 $34.67 Median $69.18 Typical High $131.83 | Professional | None | $34.67 | $69.18 | $131.83 |
Univera Setting Facility Modifier None Typical Low $27.54 Median $74.13 Typical High $177.83 | Facility | None | $27.54 | $74.13 | $177.83 |
Univera Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $109.65 | Professional | None | $56.23 | $77.62 | $109.65 |
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 $30.20 Median $41.69 Typical High $44.67 | Professional | 52 · Reduced service | $30.20 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $16.98 Typical High $17.78 | Professional | 53 · Discontinued | $12.02 | $16.98 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.59 Typical High $13.49 | Professional | 55 · Aftercare only | $9.12 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.32 Typical High $8.91 | Professional | 56 · Pre-op care only | $6.03 | $8.32 | $8.91 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $42.66 Typical High $60.26 | Professional | 53 · Discontinued | $41.69 | $42.66 | $60.26 |
Where New York sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 43rd of 51
$77.62
AK $214VA $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.