How much rates vary
Facilitymedian $3,162 · 10th to 90th $724 to $7,586Professionalmedian $501 · 10th to 90th $398 to $955
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 $537.03 Median $537.03 Typical High $1,122.02 | Professional | None | $537.03 | $537.03 | $1,122.02 |
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 $398.11 Median $478.63 Typical High $891.25 | Professional | None | $398.11 | $478.63 | $891.25 |
CDPHP Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,778.28 Typical High $2,754.23 | Facility | None | $812.83 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $512.86 Typical High $1,737.80 | Professional | None | $501.19 | $512.86 | $1,737.80 |
Emblem Health Setting Facility Modifier None Typical Low $501.19 Median $707.95 Typical High $1,862.09 | Facility | None | $501.19 | $707.95 | $1,862.09 |
Emblem Health Setting Professional Modifier None Typical Low $501.19 Median $575.44 Typical High $1,023.29 | Professional | None | $501.19 | $575.44 | $1,023.29 |
Excellus BCBS Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $691.83 | Professional | None | $316.23 | $446.68 | $691.83 |
MVP Health Care Setting Facility Modifier None Typical Low $724.44 Median $4,786.30 Typical High $5,754.40 | Facility | None | $724.44 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,258.93 | Professional | None | $831.76 | $831.76 | $1,258.93 |
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 $380.19 Median $562.34 Typical High $1,479.11 | Professional | None | $380.19 | $562.34 | $1,479.11 |
Univera Setting Facility Modifier None Typical Low $338.84 Median $457.09 Typical High $933.25 | Facility | None | $338.84 | $457.09 | $933.25 |
Univera Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $691.83 | Professional | None | $316.23 | $446.68 | $691.83 |
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 $269.15 Median $269.15 Typical High $323.59 | Professional | 52 · Reduced service | $269.15 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $131.83 | Professional | 53 · Discontinued | $107.15 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $489.78 | Professional | 54 · Surgery only | $398.11 | $398.11 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $97.72 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $64.57 |
Where New York sits
The same service costs 3.8 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
$513
WI $1,950NY $513
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.