How much rates vary
Facilitymedian $5,370 · 10th to 90th $977 to $14,125Professionalmedian $794 · 10th to 90th $603 to $1,778
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,737.80 | Professional | None | $870.96 | $870.96 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,412.54 | Professional | None | $630.96 | $758.58 | $1,412.54 |
CDPHP Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $2,630.27 | Professional | None | $794.33 | $794.33 | $2,630.27 |
Emblem Health Setting Facility Modifier None Typical Low $758.58 Median $1,047.13 Typical High $2,951.21 | Facility | None | $758.58 | $1,047.13 | $2,951.21 |
Emblem Health Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,584.89 | Professional | None | $776.25 | $912.01 | $1,584.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $1,096.48 | Professional | None | $501.19 | $676.08 | $1,096.48 |
MVP Health Care Setting Facility Modifier None Typical Low $891.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $891.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $1,995.26 | Professional | None | $1,318.26 | $1,778.28 | $1,995.26 |
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 $602.56 Median $891.25 Typical High $2,290.87 | Professional | None | $602.56 | $891.25 | $2,290.87 |
Univera Setting Facility Modifier None Typical Low $537.03 Median $724.44 Typical High $1,412.54 | Facility | None | $537.03 | $724.44 | $1,412.54 |
Univera Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $1,096.48 | Professional | None | $501.19 | $676.08 | $1,096.48 |
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 $436.52 Median $436.52 Typical High $512.86 | Professional | 52 · Reduced service | $436.52 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $204.17 | Professional | 53 · Discontinued | $173.78 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $776.25 | Professional | 54 · Surgery only | $660.69 | $660.69 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $154.88 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $102.33 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $102.33 |
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
$813
WI $3,090NY $813
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.