How much rates vary
Facilitymedian $2,692 · 10th to 90th $363 to $5,248Professionalmedian $257 · 10th to 90th $145 to $537
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 $1,174.90 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,174.90 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $275.42 Typical High $331.13 | Professional | None | $144.54 | $275.42 | $331.13 |
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 $229.09 Median $269.15 Typical High $489.78 | Professional | None | $229.09 | $269.15 | $489.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $407.38 Typical High $741.31 | Professional | 50 · Both sides | $338.84 | $407.38 | $741.31 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $380.19 | Professional | None | $186.21 | $186.21 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $562.34 Typical High $1,737.80 | Facility | None | $288.40 | $562.34 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $213.80 Typical High $870.96 | Professional | None | $104.71 | $213.80 | $870.96 |
Emblem Health Setting Facility Modifier None Typical Low $134.90 Median $165.96 Typical High $478.63 | Facility | None | $134.90 | $165.96 | $478.63 |
Emblem Health Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $562.34 | Professional | None | $295.12 | $338.84 | $562.34 |
Excellus BCBS Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $338.84 | Professional | None | $181.97 | $257.04 | $338.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $177.83 | Facility | None | $50.12 | $50.12 | $177.83 |
MVP Health Care Setting Facility Modifier None Typical Low $147.91 Median $1,819.70 Typical High $8,511.38 | Facility | None | $147.91 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $602.56 | Professional | None | $239.88 | $239.88 | $602.56 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,174.90 Typical High $4,365.16 | Facility | None | $363.08 | $1,174.90 | $4,365.16 |
United Setting Professional Modifier None Typical Low $107.15 Median $229.09 Typical High $616.60 | Professional | None | $107.15 | $229.09 | $616.60 |
Univera Setting Facility Modifier None Typical Low $97.72 Median $251.19 Typical High $524.81 | Facility | None | $97.72 | $251.19 | $524.81 |
Univera Setting Professional Modifier None Typical Low $181.97 Median $251.19 Typical High $331.13 | Professional | None | $181.97 | $251.19 | $331.13 |
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 $72.44 Median $131.83 Typical High $165.96 | Professional | 52 · Reduced service | $72.44 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $52.48 Typical High $66.07 | Professional | 53 · Discontinued | $28.84 | $52.48 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $199.53 Typical High $245.47 | Professional | 54 · Surgery only | $107.15 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $39.81 Typical High $50.12 | Professional | 55 · Aftercare only | $21.88 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $26.30 Typical High $33.11 | Professional | 56 · Pre-op care only | $14.45 | $26.30 | $33.11 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $173.78 Typical High $275.42 | Professional | 53 · Discontinued | $131.83 | $173.78 | $275.42 |
Where New York sits
The same service costs 3.2 times more in Wisconsin 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· 31st of 51
$269
WI $646KY $204
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.