How much rates vary
Facilitymedian $2,692 · 10th to 90th $363 to $5,248Professionalmedian $251 · 10th to 90th $158 to $550
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 $977.24 Median $3,981.07 Typical High $8,128.31 | Facility | None | $977.24 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $257.04 Typical High $489.78 | Professional | None | $158.49 | $257.04 | $489.78 |
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 $213.80 Median $245.47 Typical High $537.03 | Professional | None | $213.80 | $245.47 | $537.03 |
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 $398.11 | Professional | None | $186.21 | $186.21 | $398.11 |
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 $851.14 | Professional | None | $104.71 | $213.80 | $851.14 |
Emblem Health Setting Facility Modifier None Typical Low $141.25 Median $186.21 Typical High $489.78 | Facility | None | $141.25 | $186.21 | $489.78 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $575.44 | Professional | None | $302.00 | $346.74 | $575.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $181.97 Median $263.03 Typical High $338.84 | Professional | None | $181.97 | $263.03 | $338.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
MVP Health Care Setting Facility Modifier None Typical Low $263.03 Median $1,819.70 Typical High $8,511.38 | Facility | None | $263.03 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $660.69 | Professional | None | $281.84 | $281.84 | $660.69 |
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 $239.88 Typical High $630.96 | Professional | None | $107.15 | $239.88 | $630.96 |
Univera Setting Facility Modifier None Typical Low $97.72 Median $251.19 Typical High $741.31 | Facility | None | $97.72 | $251.19 | $741.31 |
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 $79.43 Median $128.82 Typical High $165.96 | Professional | 52 · Reduced service | $79.43 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $51.29 Typical High $66.07 | Professional | 53 · Discontinued | $31.62 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $190.55 Typical High $245.47 | Professional | 54 · Surgery only | $120.23 | $190.55 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $38.02 Typical High $50.12 | Professional | 55 · Aftercare only | $23.99 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $25.70 Typical High $33.11 | Professional | 56 · Pre-op care only | $15.85 | $25.70 | $33.11 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $186.21 Typical High $275.42 | Professional | 53 · Discontinued | $141.25 | $186.21 | $275.42 |
Where New York sits
The same service costs 3.1 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· 37th of 51
$257
WI $676KY $219
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.