How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,000 to $9,333Professionalmedian $191 · 10th to 90th $138 to $437
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 $1,513.56 Median $4,073.80 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,073.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $371.54 | Professional | None | $138.04 | $218.78 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $398.11 | Professional | None | $162.18 | $190.55 | $398.11 |
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 $177.83 Median $177.83 Typical High $302.00 | Professional | None | $177.83 | $177.83 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,148.15 | $2,818.38 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $165.96 Typical High $691.83 | Professional | None | $97.72 | $165.96 | $691.83 |
Emblem Health Setting Facility Modifier None Typical Low $120.23 Median $151.36 Typical High $467.74 | Facility | None | $120.23 | $151.36 | $467.74 |
Emblem Health Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $446.68 | Professional | None | $234.42 | $269.15 | $446.68 |
Excellus BCBS Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $275.42 | Professional | None | $144.54 | $208.93 | $275.42 |
MVP Health Care Setting Facility Modifier None Typical Low $138.04 Median $1,819.70 Typical High $8,511.38 | Facility | None | $138.04 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $524.81 | Professional | None | $234.42 | $234.42 | $524.81 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,943.28 | Facility | None | $1,122.02 | $2,754.23 | $7,943.28 |
United Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $512.86 | Professional | None | $102.33 | $190.55 | $512.86 |
Univera Setting Facility Modifier None Typical Low $95.50 Median $194.98 Typical High $416.87 | Facility | None | $95.50 | $194.98 | $416.87 |
Univera Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $263.03 | Professional | None | $144.54 | $194.98 | $263.03 |
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 $69.18 Median $107.15 Typical High $128.82 | Professional | 52 · Reduced service | $69.18 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $43.65 Typical High $51.29 | Professional | 53 · Discontinued | $27.54 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $162.18 Typical High $194.98 | Professional | 54 · Surgery only | $102.33 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $32.36 Typical High $38.90 | Professional | 55 · Aftercare only | $20.42 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $21.88 Typical High $25.70 | Professional | 56 · Pre-op care only | $13.80 | $21.88 | $25.70 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $141.25 Typical High $218.78 | Professional | 53 · Discontinued | $104.71 | $141.25 | $218.78 |
Where New York sits
The same service costs 3.7 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· 50th of 51
$200
AK $708KY $191
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.