How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,202 to $11,220Professionalmedian $1,000 · 10th to 90th $251 to $1,622
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 $1,445.44 Median $5,248.07 Typical High $12,302.69 | Facility | None | $1,445.44 | $5,248.07 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $1,071.52 Typical High $1,445.44 | Professional | None | $257.04 | $1,071.52 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $5,495.41 Typical High $12,302.69 | Facility | None | $3,467.37 | $5,495.41 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,548.82 | Professional | None | $912.01 | $1,071.52 | $1,548.82 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $1,584.89 | Professional | None | $295.12 | $295.12 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $602.56 Typical High $1,737.80 | Professional | None | $199.53 | $602.56 | $1,737.80 |
Emblem Health Setting Facility Modifier None Typical Low $154.88 Median $234.42 Typical High $724.44 | Facility | None | $154.88 | $234.42 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,096.48 | $1,288.25 | $1,862.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,479.11 | Professional | None | $660.69 | $977.24 | $1,479.11 |
Highmark BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,168.69 | Facility | None | $4,168.69 | $4,168.69 | $4,168.69 |
MVP Health Care Setting Facility Modifier None Typical Low $263.03 Median $3,235.94 Typical High $4,365.16 | Facility | None | $263.03 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $2,691.53 | Professional | None | $309.03 | $309.03 | $2,691.53 |
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 $199.53 Median $758.58 Typical High $1,737.80 | Professional | None | $199.53 | $758.58 | $1,737.80 |
Univera Setting Facility Modifier None Typical Low $151.36 Median $275.42 Typical High $1,230.27 | Facility | None | $151.36 | $275.42 | $1,230.27 |
Univera Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,479.11 | Professional | None | $660.69 | $977.24 | $1,479.11 |
8 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 $128.82 Median $478.63 Typical High $645.65 | Professional | 52 · Reduced service | $128.82 | $478.63 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $190.55 Typical High $257.04 | Professional | 53 · Discontinued | $51.29 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $707.95 Typical High $954.99 | Professional | 54 · Surgery only | $190.55 | $707.95 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $141.25 Typical High $190.55 | Professional | 55 · Aftercare only | $38.90 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $95.50 Typical High $128.82 | Professional | 56 · Pre-op care only | $25.70 | $95.50 | $128.82 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $1,071.52 Median $1,258.93 Typical High $1,288.25 | Professional | GL · Free upgrade | $1,071.52 | $1,258.93 | $1,288.25 |
Highmark BCBS Setting Professional Modifier XS · Separate structure Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | XS · Separate structure | $257.04 | $257.04 | $257.04 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $707.95 Typical High $1,023.29 | Professional | 53 · Discontinued | $562.34 | $707.95 | $1,023.29 |
Where New York sits
The same service costs 4.1 times more in Washington 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· 18th of 51
$1,023
WA $1,549NE $380
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.