How much rates vary
Facilitymedian $2,291 · 10th to 90th $182 to $4,467Professionalmedian $115 · 10th to 90th $81 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 $85.11 Median $117.49 Typical High $288.40 | Facility | None | $85.11 | $117.49 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $125.89 | Professional | None | $85.11 | $117.49 | $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 $97.72 Median $114.82 Typical High $162.18 | Professional | None | $97.72 | $114.82 | $162.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $144.54 Median $169.82 Typical High $234.42 | Professional | 50 · Both sides | $144.54 | $169.82 | $234.42 |
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 $114.82 Median $114.82 Typical High $169.82 | Professional | None | $114.82 | $114.82 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $144.54 Typical High $331.13 | Facility | None | $100.00 | $144.54 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $269.15 | Professional | None | $81.28 | $117.49 | $269.15 |
Emblem Health Setting Facility Modifier None Typical Low $77.62 Median $95.50 Typical High $302.00 | Facility | None | $77.62 | $95.50 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $245.47 | Professional | None | $109.65 | $162.18 | $245.47 |
Excellus BCBS Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $165.96 | Professional | None | $70.79 | $123.03 | $165.96 |
MVP Health Care Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
MVP Health Care Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $331.13 | Professional | None | $102.33 | $102.33 | $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 $66.07 Median $112.20 Typical High $223.87 | Professional | None | $66.07 | $112.20 | $223.87 |
Univera Setting Facility Modifier None Typical Low $54.95 Median $109.65 Typical High $323.59 | Facility | None | $54.95 | $109.65 | $323.59 |
Univera Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $165.96 | Professional | None | $83.18 | $109.65 | $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 $42.66 Median $58.88 Typical High $63.10 | Professional | 52 · Reduced service | $42.66 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $23.44 Typical High $25.12 | Professional | 53 · Discontinued | $16.98 | $23.44 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $17.78 Typical High $18.62 | Professional | 55 · Aftercare only | $12.88 | $17.78 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $11.75 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.51 | $11.75 | $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 3.5 times more in Alaska than in Maryland. 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
$115
AK $339MD $95.50
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.