How much rates vary
Facilitymedian $2,512 · 10th to 90th $145 to $5,012Professionalmedian $155 · 10th to 90th $62 to $275
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 $67.61 Median $2,511.89 Typical High $7,762.47 | Facility | None | $67.61 | $2,511.89 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $251.19 | Professional | None | $60.26 | $100.00 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
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 $138.04 Median $169.82 Typical High $245.47 | Professional | None | $138.04 | $169.82 | $245.47 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $204.17 Median $257.04 Typical High $371.54 | Professional | 50 · Both sides | $204.17 | $257.04 | $371.54 |
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 $79.43 Median $79.43 Typical High $223.87 | Professional | None | $79.43 | $79.43 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $100.00 Typical High $1,096.48 | Facility | None | $89.13 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $125.89 Typical High $389.05 | Professional | None | $44.67 | $125.89 | $389.05 |
Emblem Health Setting Facility Modifier None Typical Low $39.81 Median $61.66 Typical High $194.98 | Facility | None | $39.81 | $61.66 | $194.98 |
Emblem Health Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $338.84 | Professional | None | $190.55 | $208.93 | $338.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $194.98 | Professional | None | $87.10 | $144.54 | $194.98 |
Highmark BCBS Setting Facility Modifier None Typical Low $102.33 Median $512.86 Typical High $1,202.26 | Facility | None | $102.33 | $512.86 | $1,202.26 |
MVP Health Care Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
MVP Health Care Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $363.08 | Professional | None | $75.86 | $75.86 | $363.08 |
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 $44.67 Median $125.89 Typical High $316.23 | Professional | None | $44.67 | $125.89 | $316.23 |
Univera Setting Facility Modifier None Typical Low $40.74 Median $144.54 Typical High $229.09 | Facility | None | $40.74 | $144.54 | $229.09 |
Univera Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $186.21 | Professional | None | $87.10 | $144.54 | $186.21 |
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 $29.51 Median $50.12 Typical High $95.50 | Professional | 52 · Reduced service | $29.51 | $50.12 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $19.95 Typical High $38.02 | Professional | 53 · Discontinued | $12.02 | $19.95 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $75.86 Typical High $144.54 | Professional | 54 · Surgery only | $44.67 | $75.86 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $15.14 Typical High $28.84 | Professional | 55 · Aftercare only | $8.91 | $15.14 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $10.00 Typical High $19.05 | Professional | 56 · Pre-op care only | $6.03 | $10.00 | $19.05 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $95.50 Typical High $154.88 | Professional | 53 · Discontinued | $72.44 | $95.50 | $154.88 |
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· 10th of 51
$158
AK $316KY $79.43
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.