How much rates vary
Facilitymedian $3,981 · 10th to 90th $676 to $8,318Professionalmedian $589 · 10th to 90th $166 to $891
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 $676.08 Median $4,168.69 Typical High $10,471.29 | Facility | None | $676.08 | $4,168.69 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $602.56 Typical High $831.76 | Professional | None | $169.82 | $602.56 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $4,466.84 Typical High $9,120.11 | Facility | None | $2,570.40 | $4,466.84 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $870.96 | Professional | None | $537.03 | $630.96 | $870.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $933.25 Typical High $1,288.25 | Professional | 50 · Both sides | $794.33 | $933.25 | $1,288.25 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $870.96 | Professional | None | $194.98 | $194.98 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $389.05 Typical High $977.24 | Professional | None | $138.04 | $389.05 | $977.24 |
Emblem Health Setting Facility Modifier None Typical Low $97.72 Median $151.36 Typical High $478.63 | Facility | None | $97.72 | $151.36 | $478.63 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $1,000.00 | Professional | None | $616.60 | $676.08 | $1,000.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $831.76 | Professional | None | $371.54 | $537.03 | $831.76 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,202.26 | Professional | None | $1,148.15 | $1,148.15 | $1,202.26 |
MVP Health Care Setting Facility Modifier None Typical Low $165.96 Median $3,235.94 Typical High $4,365.16 | Facility | None | $165.96 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $1,479.11 | Professional | None | $204.17 | $204.17 | $1,479.11 |
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 $131.83 Median $426.58 Typical High $977.24 | Professional | None | $131.83 | $426.58 | $977.24 |
Univera Setting Facility Modifier None Typical Low $97.72 Median $177.83 Typical High $1,288.25 | Facility | None | $97.72 | $177.83 | $1,288.25 |
Univera Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $724.44 | Professional | None | $371.54 | $537.03 | $724.44 |
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 $85.11 Median $295.12 Typical High $363.08 | Professional | 52 · Reduced service | $85.11 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $117.49 Typical High $144.54 | Professional | 53 · Discontinued | $34.67 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $436.52 Typical High $549.54 | Professional | 54 · Surgery only | $128.82 | $436.52 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $87.10 Typical High $109.65 | Professional | 55 · Aftercare only | $25.70 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $58.88 Typical High $72.44 | Professional | 56 · Pre-op care only | $16.98 | $58.88 | $72.44 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $645.65 Median $758.58 Typical High $758.58 | Professional | GL · Free upgrade | $645.65 | $758.58 | $758.58 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $389.05 Typical High $575.44 | Professional | 53 · Discontinued | $309.03 | $389.05 | $575.44 |
Where New York sits
The same service costs 3.8 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· 20th of 51
$589
WI $912NE $240
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.