How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,096 to $28,184Professionalmedian $4,571 · 10th to 90th $100 to $8,128
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 $117.49 Median $4,677.35 Typical High $9,120.11 | Facility | None | $117.49 | $4,677.35 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $4,365.16 Typical High $6,760.83 | Professional | None | $100.00 | $4,365.16 | $6,760.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,912.51 Typical High $66,069.34 | Facility | None | $1,737.80 | $8,912.51 | $66,069.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,981.07 Median $4,897.79 Typical High $8,511.38 | Professional | None | $3,981.07 | $4,897.79 | $8,511.38 |
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 $123.03 Median $123.03 Typical High $7,079.46 | Professional | None | $123.03 | $123.03 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $10,964.78 Typical High $23,442.29 | Facility | None | $1,445.44 | $10,964.78 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $323.59 Typical High $9,120.11 | Professional | None | $87.10 | $323.59 | $9,120.11 |
Emblem Health Setting Facility Modifier None Typical Low $91.20 Median $151.36 Typical High $316.23 | Facility | None | $91.20 | $151.36 | $316.23 |
Emblem Health Setting Professional Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $8,912.51 | Professional | None | $4,365.16 | $5,128.61 | $8,912.51 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $3,801.89 Typical High $6,309.57 | Professional | None | $1,778.28 | $3,801.89 | $6,309.57 |
Highmark BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $9,772.37 Typical High $14,454.40 | Facility | None | $3,090.30 | $9,772.37 | $14,454.40 |
Highmark BCBS Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $6,165.95 | Professional | None | $79.43 | $79.43 | $6,165.95 |
MVP Health Care Setting Facility Modifier None Typical Low $109.65 Median $3,235.94 Typical High $4,365.16 | Facility | None | $109.65 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $11,220.18 | Professional | None | $4,677.35 | $4,677.35 | $11,220.18 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,677.35 Typical High $23,988.33 | Facility | None | $1,380.38 | $4,677.35 | $23,988.33 |
United Setting Professional Modifier None Typical Low $79.43 Median $630.96 Typical High $8,912.51 | Professional | None | $79.43 | $630.96 | $8,912.51 |
Univera Setting Facility Modifier None Typical Low $57.54 Median $141.25 Typical High $6,456.54 | Facility | None | $57.54 | $141.25 | $6,456.54 |
Univera Setting Professional Modifier None Typical Low $1,778.28 Median $3,801.89 Typical High $6,309.57 | Professional | None | $1,778.28 | $3,801.89 | $6,309.57 |
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 $48.98 Median $2,818.38 Typical High $3,090.30 | Professional | 52 · Reduced service | $48.98 | $2,818.38 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $1,122.02 Typical High $1,230.27 | Professional | 53 · Discontinued | $19.95 | $1,122.02 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $4,265.80 Typical High $4,677.35 | Professional | 54 · Surgery only | $74.13 | $4,265.80 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $851.14 Typical High $933.25 | Professional | 55 · Aftercare only | $14.79 | $851.14 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $562.34 Typical High $616.60 | Professional | 56 · Pre-op care only | $10.00 | $562.34 | $616.60 |
Where New York sits
The same service costs 6.2 times more in Alaska than in Vermont. 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.
Physician feeFacility fee
AK $20,033VT $3,256
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.