How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,288 to $11,220Professionalmedian $1,000 · 10th to 90th $309 to $1,660
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 $1,479.11 Median $5,370.32 Typical High $12,302.69 | Facility | None | $1,479.11 | $5,370.32 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $1,174.90 Typical High $1,479.11 | Professional | None | $309.03 | $1,174.90 | $1,479.11 |
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 $870.96 Median $1,023.29 Typical High $1,621.81 | Professional | None | $870.96 | $1,023.29 | $1,621.81 |
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 $380.19 Median $380.19 Typical High $1,621.81 | Professional | None | $380.19 | $380.19 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Facility | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $758.58 Typical High $1,862.09 | Professional | None | $263.03 | $758.58 | $1,862.09 |
Emblem Health Setting Facility Modifier None Typical Low $181.97 Median $295.12 Typical High $954.99 | Facility | None | $181.97 | $295.12 | $954.99 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,905.46 | Professional | None | $1,174.90 | $1,288.25 | $1,905.46 |
Excellus BCBS Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,412.54 | Professional | None | $676.08 | $933.25 | $1,412.54 |
MVP Health Care Setting Facility Modifier None Typical Low $295.12 Median $3,235.94 Typical High $4,365.16 | Facility | None | $295.12 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $2,884.03 | Professional | None | $346.74 | $346.74 | $2,884.03 |
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 $251.19 Median $812.83 Typical High $1,862.09 | Professional | None | $251.19 | $812.83 | $1,862.09 |
Univera Setting Facility Modifier None Typical Low $190.55 Median $346.74 Typical High $1,445.44 | Facility | None | $190.55 | $346.74 | $1,445.44 |
Univera Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,412.54 | Professional | None | $676.08 | $1,000.00 | $1,412.54 |
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 $151.36 Median $537.03 Typical High $691.83 | Professional | 52 · Reduced service | $151.36 | $537.03 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $213.80 Typical High $281.84 | Professional | 53 · Discontinued | $61.66 | $213.80 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $794.33 Typical High $1,047.13 | Professional | 54 · Surgery only | $229.09 | $794.33 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $158.49 Typical High $208.93 | Professional | 55 · Aftercare only | $45.71 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $107.15 Typical High $138.04 | Professional | 56 · Pre-op care only | $30.90 | $107.15 | $138.04 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $1,174.90 Median $1,380.38 Typical High $1,380.38 | Professional | GL · Free upgrade | $1,174.90 | $1,380.38 | $1,380.38 |
Highmark BCBS Setting Professional Modifier 59 · Distinct service Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | 59 · Distinct service | $1,862.09 | $1,862.09 | $1,862.09 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $758.58 Typical High $1,047.13 | Professional | 53 · Discontinued | $588.84 | $758.58 | $1,047.13 |
Where New York sits
The same service costs 3.5 times more in Wisconsin than in Maryland. 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· 25th of 51
$1,000
WI $1,660MD $468
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.