How much rates vary
Facilitymedian $2,291 · 10th to 90th $107 to $4,467Professionalmedian $76 · 10th to 90th $15 to $110
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 $15.14 Median $70.79 Typical High $181.97 | Facility | None | $15.14 | $70.79 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $15.14 Median $70.79 Typical High $79.43 | Professional | None | $15.14 | $70.79 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | None | $13.18 | $13.18 | $13.18 |
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 $72.44 Median $85.11 Typical High $95.50 | Professional | None | $72.44 | $85.11 | $95.50 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $128.82 Typical High $141.25 | Professional | 50 · Both sides | $109.65 | $128.82 | $141.25 |
CDPHP Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $16,595.87 | Facility | None | $5,495.41 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $120.23 | Professional | None | $22.91 | $22.91 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $138.04 Typical High $371.54 | Facility | None | $79.43 | $138.04 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $66.07 Typical High $151.36 | Professional | None | $13.49 | $66.07 | $151.36 |
Emblem Health Setting Facility Modifier None Typical Low $14.13 Median $18.20 Typical High $53.70 | Facility | None | $14.13 | $18.20 | $53.70 |
Emblem Health Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $134.90 | Professional | None | $74.13 | $89.13 | $134.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $43.65 Median $70.79 Typical High $102.33 | Professional | None | $43.65 | $70.79 | $102.33 |
MVP Health Care Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
MVP Health Care Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $151.36 | Professional | None | $67.61 | $67.61 | $151.36 |
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 $12.59 Median $45.71 Typical High $120.23 | Professional | None | $12.59 | $45.71 | $120.23 |
Univera Setting Facility Modifier None Typical Low $10.72 Median $39.81 Typical High $102.33 | Facility | None | $10.72 | $39.81 | $102.33 |
Univera Setting Professional Modifier None Typical Low $43.65 Median $70.79 Typical High $102.33 | Professional | None | $43.65 | $70.79 | $102.33 |
4 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 $7.59 Median $35.48 Typical High $39.81 | Professional | 52 · Reduced service | $7.59 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.02 Median $14.13 Typical High $15.85 | Professional | 53 · Discontinued | $3.02 | $14.13 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.24 Median $10.47 Typical High $12.02 | Professional | 55 · Aftercare only | $2.24 | $10.47 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.51 Median $7.08 Typical High $7.94 | Professional | 56 · Pre-op care only | $1.51 | $7.08 | $7.94 |
Where New York sits
The same service costs 5.9 times more in Iowa 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· 21st of 51
$77.62
IA $117KY $19.95
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.