How much rates vary
Facilitymedian $3,162 · 10th to 90th $708 to $7,586Professionalmedian $479 · 10th to 90th $380 to $912
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 $512.86 Median $512.86 Typical High $1,047.13 | Professional | None | $512.86 | $512.86 | $1,047.13 |
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 $380.19 Median $457.09 Typical High $851.14 | Professional | None | $380.19 | $457.09 | $851.14 |
CDPHP Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
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 $478.63 Median $501.19 Typical High $1,698.24 | Professional | None | $478.63 | $501.19 | $1,698.24 |
Emblem Health Setting Facility Modifier None Typical Low $489.78 Median $660.69 Typical High $1,778.28 | Facility | None | $489.78 | $660.69 | $1,778.28 |
Emblem Health Setting Professional Modifier None Typical Low $467.74 Median $549.54 Typical High $954.99 | Professional | None | $467.74 | $549.54 | $954.99 |
Excellus BCBS Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $645.65 | Professional | None | $302.00 | $426.58 | $645.65 |
MVP Health Care Setting Facility Modifier None Typical Low $707.95 Median $4,786.30 Typical High $5,754.40 | Facility | None | $707.95 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,202.26 | Professional | None | $812.83 | $812.83 | $1,202.26 |
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 $363.08 Median $549.54 Typical High $1,380.38 | Professional | None | $363.08 | $549.54 | $1,380.38 |
Univera Setting Facility Modifier None Typical Low $323.59 Median $426.58 Typical High $912.01 | Facility | None | $323.59 | $426.58 | $912.01 |
Univera Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $645.65 | Professional | None | $302.00 | $426.58 | $645.65 |
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 $257.04 Median $257.04 Typical High $309.03 | Professional | 52 · Reduced service | $257.04 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | 53 · Discontinued | $102.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $467.74 | Professional | 54 · Surgery only | $389.05 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $93.33 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $61.66 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $61.66 |
Where New York sits
The same service costs 3.9 times more in Wisconsin 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
$490
WI $1,905NY $490
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.