How much rates vary
Facilitymedian $2,399 · 10th to 90th $41 to $4,467Professionalmedian $25 · 10th to 90th $10 to $45
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 $10.00 Median $27.54 Typical High $3,548.13 | Facility | None | $10.00 | $27.54 | $3,548.13 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $27.54 Typical High $40.74 | Professional | None | $10.00 | $27.54 | $40.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $24.55 Typical High $38.02 | Professional | None | $20.42 | $24.55 | $38.02 |
CDPHP Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $41.69 | Professional | None | $12.59 | $12.59 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $1,778.28 Typical High $1,949.84 | Facility | None | $14.45 | $1,778.28 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $27.54 Typical High $66.07 | Professional | None | $7.76 | $27.54 | $66.07 |
Emblem Health Setting Facility Modifier None Typical Low $9.33 Median $15.85 Typical High $33.11 | Facility | None | $9.33 | $15.85 | $33.11 |
Emblem Health Setting Professional Modifier None Typical Low $20.42 Median $25.70 Typical High $33.88 | Professional | None | $20.42 | $25.70 | $33.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $20.42 Median $28.18 Typical High $42.66 | Professional | None | $20.42 | $28.18 | $42.66 |
Highmark BCBS Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $43.65 | Facility | None | $22.39 | $22.39 | $43.65 |
MVP Health Care Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
MVP Health Care Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $69.18 | Professional | None | $19.95 | $19.95 | $69.18 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $7.94 Median $24.55 Typical High $52.48 | Professional | None | $7.94 | $24.55 | $52.48 |
Univera Setting Facility Modifier None Typical Low $6.46 Median $20.42 Typical High $77.62 | Facility | None | $6.46 | $20.42 | $77.62 |
Univera Setting Professional Modifier None Typical Low $20.42 Median $28.18 Typical High $42.66 | Professional | None | $20.42 | $28.18 | $42.66 |
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 $5.01 Median $13.80 Typical High $20.42 | Professional | 52 · Reduced service | $5.01 | $13.80 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $5.50 Typical High $8.13 | Professional | 53 · Discontinued | $2.00 | $5.50 | $8.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.41 Median $20.42 Typical High $30.20 | Professional | 54 · Surgery only | $7.41 | $20.42 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $4.07 Typical High $6.03 | Professional | 55 · Aftercare only | $1.51 | $4.07 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $2.75 Typical High $4.07 | Professional | 56 · Pre-op care only | $1.00 | $2.75 | $4.07 |
Where New York sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 48th of 51
$25.70
WI $67.61NE $16.22
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.