How much rates vary
Facilitymedian $3,162 · 10th to 90th $646 to $7,586Professionalmedian $309 · 10th to 90th $245 to $603
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 $1,621.81 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,621.81 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $812.83 | Professional | None | $338.84 | $338.84 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $549.54 | Professional | None | $245.47 | $295.12 | $549.54 |
CDPHP Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $2,754.23 | Facility | None | $794.33 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $316.23 Typical High $1,023.29 | Professional | None | $309.03 | $316.23 | $1,023.29 |
Emblem Health Setting Facility Modifier None Typical Low $302.00 Median $407.38 Typical High $1,148.15 | Facility | None | $302.00 | $407.38 | $1,148.15 |
Emblem Health Setting Professional Modifier None Typical Low $309.03 Median $354.81 Typical High $616.60 | Professional | None | $309.03 | $354.81 | $616.60 |
Excellus BCBS Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $436.52 | Professional | None | $204.17 | $263.03 | $436.52 |
MVP Health Care Setting Facility Modifier None Typical Low $389.05 Median $3,235.94 Typical High $4,365.16 | Facility | None | $389.05 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $794.33 | Professional | None | $426.58 | $426.58 | $794.33 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $234.42 Median $354.81 Typical High $912.01 | Professional | None | $234.42 | $354.81 | $912.01 |
Univera Setting Facility Modifier None Typical Low $213.80 Median $281.84 Typical High $562.34 | Facility | None | $213.80 | $281.84 | $562.34 |
Univera Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $436.52 | Professional | None | $204.17 | $263.03 | $436.52 |
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 $169.82 Median $169.82 Typical High $204.17 | Professional | 52 · Reduced service | $169.82 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $83.18 | Professional | 53 · Discontinued | $67.61 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $251.19 Typical High $309.03 | Professional | 54 · Surgery only | $251.19 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $61.66 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $40.74 |
Where New York sits
The same service costs 6.1 times more in Alaska than in Maryland. 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 $5,496MD $901
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.