How much rates vary
Facilitymedian $3,388 · 10th to 90th $851 to $6,457Professionalmedian $550 · 10th to 90th $174 to $813
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 $1,348.96 Median $4,365.16 Typical High $10,232.93 | Facility | None | $1,348.96 | $4,365.16 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $549.54 Typical High $707.95 | Professional | None | $173.78 | $549.54 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,548.13 Typical High $4,897.79 | Facility | None | $1,819.70 | $3,548.13 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $758.58 | Professional | None | $489.78 | $575.44 | $758.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $870.96 Typical High $1,096.48 | Professional | 50 · Both sides | $741.31 | $870.96 | $1,096.48 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $851.14 | Professional | None | $218.78 | $218.78 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $416.87 Typical High $870.96 | Professional | None | $151.36 | $416.87 | $870.96 |
Emblem Health Setting Facility Modifier None Typical Low $97.72 Median $162.18 Typical High $524.81 | Facility | None | $97.72 | $162.18 | $524.81 |
Emblem Health Setting Professional Modifier None Typical Low $562.34 Median $616.60 Typical High $912.01 | Professional | None | $562.34 | $616.60 | $912.01 |
Excellus BCBS Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $724.44 | Professional | None | $346.74 | $478.63 | $724.44 |
MVP Health Care Setting Facility Modifier None Typical Low $173.78 Median $3,235.94 Typical High $4,365.16 | Facility | None | $173.78 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $1,318.26 | Professional | None | $199.53 | $199.53 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $2,951.21 Typical High $5,011.87 | Facility | None | $1,318.26 | $2,951.21 | $5,011.87 |
United Setting Professional Modifier None Typical Low $141.25 Median $436.52 Typical High $870.96 | Professional | None | $141.25 | $436.52 | $870.96 |
Univera Setting Facility Modifier None Typical Low $104.71 Median $190.55 Typical High $1,096.48 | Facility | None | $104.71 | $190.55 | $1,096.48 |
Univera Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $707.95 | Professional | None | $346.74 | $489.78 | $707.95 |
7 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 $87.10 Median $269.15 Typical High $331.13 | Professional | 52 · Reduced service | $87.10 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $109.65 Typical High $131.83 | Professional | 53 · Discontinued | $34.67 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $407.38 Typical High $489.78 | Professional | 54 · Surgery only | $128.82 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $81.28 Typical High $100.00 | Professional | 55 · Aftercare only | $25.70 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $54.95 Typical High $66.07 | Professional | 56 · Pre-op care only | $17.38 | $54.95 | $66.07 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $512.86 Median $602.56 Typical High $602.56 | Professional | GL · Free upgrade | $512.86 | $602.56 | $602.56 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $346.74 Typical High $524.81 | Professional | 53 · Discontinued | $275.42 | $346.74 | $524.81 |
Where New York sits
The same service costs 3.5 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· 14th of 51
$550
WI $912NE $257
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.