How much rates vary
Facilitymedian $1,862 · 10th to 90th $66 to $4,467Professionalmedian $62 · 10th to 90th $40 to $102
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 $40.74 Median $67.61 Typical High $186.21 | Facility | None | $40.74 | $67.61 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $66.07 Typical High $87.10 | Professional | None | $39.81 | $66.07 | $87.10 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $64.57 Typical High $89.13 | Professional | None | $32.36 | $64.57 | $89.13 |
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 $52.48 Median $61.66 Typical High $83.18 | Professional | None | $52.48 | $61.66 | $83.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $79.43 Median $93.33 Typical High $125.89 | Professional | 50 · Both sides | $79.43 | $93.33 | $125.89 |
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 $56.23 Median $56.23 Typical High $91.20 | Professional | None | $56.23 | $56.23 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $100.00 Typical High $1,096.48 | Facility | None | $70.79 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $61.66 Typical High $147.91 | Professional | None | $38.02 | $61.66 | $147.91 |
Emblem Health Setting Facility Modifier None Typical Low $41.69 Median $52.48 Typical High $169.82 | Facility | None | $41.69 | $52.48 | $169.82 |
Emblem Health Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $141.25 | Professional | None | $58.88 | $95.50 | $141.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $38.90 Median $67.61 Typical High $89.13 | Professional | None | $38.90 | $67.61 | $89.13 |
Highmark BCBS Setting Facility Modifier None Typical Low $79.43 Median $154.88 Typical High $512.86 | Facility | None | $79.43 | $154.88 | $512.86 |
Highmark BCBS Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $117.49 | Professional | None | $64.57 | $85.11 | $117.49 |
MVP Health Care Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
MVP Health Care Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $177.83 | Professional | None | $41.69 | $41.69 | $177.83 |
United Setting Facility Modifier None Typical Low $338.84 Median $1,148.15 Typical High $4,365.16 | Facility | None | $338.84 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $32.36 Median $56.23 Typical High $112.20 | Professional | None | $32.36 | $56.23 | $112.20 |
Univera Setting Facility Modifier None Typical Low $26.92 Median $58.88 Typical High $208.93 | Facility | None | $26.92 | $58.88 | $208.93 |
Univera Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $89.13 | Professional | None | $45.71 | $64.57 | $89.13 |
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 $19.95 Median $32.36 Typical High $33.11 | Professional | 52 · Reduced service | $19.95 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $13.18 Typical High $13.49 | Professional | 53 · Discontinued | $7.94 | $13.18 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $9.77 Typical High $10.00 | Professional | 55 · Aftercare only | $6.03 | $9.77 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $6.61 Typical High $6.76 | Professional | 56 · Pre-op care only | $3.98 | $6.61 | $6.76 |
Fidelis Setting Professional Modifier 59 · Distinct service Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 59 · Distinct service | $91.20 | $91.20 | $91.20 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.88 Typical High $47.86 | Professional | 53 · Discontinued | $33.11 | $33.88 | $47.86 |
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· 43rd of 51
$61.66
AK $195KY $48.98
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.