How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,259 to $13,183Professionalmedian $200 · 10th to 90th $155 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 $1,819.70 Median $4,677.35 Typical High $9,120.11 | Facility | None | $1,819.70 | $4,677.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $741.31 | Professional | None | $223.87 | $223.87 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $7,413.10 Typical High $14,454.40 | Facility | None | $1,659.59 | $7,413.10 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $363.08 | Professional | None | $165.96 | $194.98 | $363.08 |
CDPHP Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $16,595.87 | Facility | None | $5,495.41 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $5,754.40 Typical High $12,022.64 | Facility | None | $1,862.09 | $5,754.40 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $251.19 Typical High $851.14 | Professional | None | $147.91 | $251.19 | $851.14 |
Emblem Health Setting Facility Modifier None Typical Low $190.55 Median $316.23 Typical High $776.25 | Facility | None | $190.55 | $316.23 | $776.25 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $354.81 | Professional | None | $204.17 | $234.42 | $354.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $269.15 | Professional | None | $131.83 | $173.78 | $269.15 |
MVP Health Care Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $489.78 | Professional | None | $309.03 | $309.03 | $489.78 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,162.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $549.54 | Professional | None | $141.25 | $218.78 | $549.54 |
Univera Setting Facility Modifier None Typical Low $144.54 Median $223.87 Typical High $426.58 | Facility | None | $144.54 | $223.87 | $426.58 |
Univera Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $245.47 | Professional | None | $123.03 | $173.78 | $245.47 |
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 $112.20 Median $112.20 Typical High $123.03 | Professional | 52 · Reduced service | $112.20 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $48.98 | Professional | 53 · Discontinued | $45.71 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $169.82 Typical High $186.21 | Professional | 54 · Surgery only | $169.82 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $33.88 Typical High $37.15 | Professional | 55 · Aftercare only | $33.88 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $24.55 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $24.55 |
Where New York sits
The same service costs 6.9 times more in Tennessee than in New York. 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· 51st of 51
$204
TN $1,413NY $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.