How much rates vary
Facilitymedian $2,291 · 10th to 90th $204 to $4,467Professionalmedian $112 · 10th to 90th $85 to $195
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 $120.23 Typical High $288.40 | Facility | None | $89.13 | $120.23 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $125.89 | Professional | None | $89.13 | $120.23 | $125.89 |
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 $95.50 Median $112.20 Typical High $162.18 | Professional | None | $95.50 | $112.20 | $162.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $144.54 Median $169.82 Typical High $245.47 | Professional | 50 · Both sides | $144.54 | $169.82 | $245.47 |
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 $120.23 Median $120.23 Typical High $169.82 | Professional | None | $120.23 | $120.23 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $363.08 | Facility | None | $100.00 | $162.18 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $275.42 | Professional | None | $85.11 | $117.49 | $275.42 |
Emblem Health Setting Facility Modifier None Typical Low $39.81 Median $97.72 Typical High $323.59 | Facility | None | $39.81 | $97.72 | $323.59 |
Emblem Health Setting Professional Modifier None Typical Low $112.20 Median $165.96 Typical High $251.19 | Professional | None | $112.20 | $165.96 | $251.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $72.44 Median $125.89 Typical High $165.96 | Professional | None | $72.44 | $125.89 | $165.96 |
MVP Health Care Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
MVP Health Care Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $331.13 | Professional | None | $125.89 | $125.89 | $331.13 |
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 $72.44 Median $112.20 Typical High $223.87 | Professional | None | $72.44 | $112.20 | $223.87 |
Univera Setting Facility Modifier None Typical Low $58.88 Median $112.20 Typical High $338.84 | Facility | None | $58.88 | $112.20 | $338.84 |
Univera Setting Professional Modifier None Typical Low $85.11 Median $112.20 Typical High $165.96 | Professional | None | $85.11 | $112.20 | $165.96 |
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 $44.67 Median $60.26 Typical High $63.10 | Professional | 52 · Reduced service | $44.67 | $60.26 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $24.55 Typical High $25.12 | Professional | 53 · Discontinued | $18.20 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $18.20 Typical High $19.05 | Professional | 55 · Aftercare only | $13.49 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.02 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.91 | $12.02 | $12.59 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $64.57 Typical High $93.33 | Professional | 53 · Discontinued | $63.10 | $64.57 | $93.33 |
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· 43rd of 51
$112
AK $355KY $97.72
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.