How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,349 to $11,220Professionalmedian $1,905 · 10th to 90th $363 to $2,818
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 $1,819.70 Median $5,370.32 Typical High $12,302.69 | Facility | None | $1,819.70 | $5,370.32 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $1,905.46 Typical High $2,454.71 | Professional | None | $363.08 | $1,905.46 | $2,454.71 |
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 $1,737.80 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,737.80 | $2,041.74 | $2,691.53 |
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 $457.09 Median $457.09 Typical High $2,691.53 | Professional | None | $457.09 | $457.09 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $912.01 Typical High $3,090.30 | Professional | None | $316.23 | $912.01 | $3,090.30 |
Emblem Health Setting Facility Modifier None Typical Low $218.78 Median $371.54 Typical High $1,174.90 | Facility | None | $218.78 | $371.54 | $1,174.90 |
Emblem Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $3,467.37 | Professional | None | $2,137.96 | $2,398.83 | $3,467.37 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,621.81 | $2,454.71 |
Highmark BCBS Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Professional | None | $3,090.30 | $3,090.30 | $3,090.30 |
MVP Health Care Setting Facility Modifier None Typical Low $354.81 Median $3,235.94 Typical High $4,365.16 | Facility | None | $354.81 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $4,786.30 | Professional | None | $426.58 | $426.58 | $4,786.30 |
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 $309.03 Median $1,380.38 Typical High $3,162.28 | Professional | None | $309.03 | $1,380.38 | $3,162.28 |
Univera Setting Facility Modifier None Typical Low $234.42 Median $426.58 Typical High $1,737.80 | Facility | None | $234.42 | $426.58 | $1,737.80 |
Univera Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,659.59 | $2,454.71 |
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 $181.97 Median $851.14 Typical High $1,148.15 | Professional | 52 · Reduced service | $181.97 | $851.14 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $338.84 Typical High $457.09 | Professional | 53 · Discontinued | $72.44 | $338.84 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $1,288.25 Typical High $1,698.24 | Professional | 54 · Surgery only | $275.42 | $1,288.25 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $257.04 Typical High $346.74 | Professional | 55 · Aftercare only | $54.95 | $257.04 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $169.82 Typical High $229.09 | Professional | 56 · Pre-op care only | $36.31 | $169.82 | $229.09 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | GL · Free upgrade | $2,511.89 | $2,511.89 | $2,511.89 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $1,258.93 Typical High $1,778.28 | Professional | 53 · Discontinued | $1,000.00 | $1,258.93 | $1,778.28 |
Where New York sits
The same service costs 5.5 times more in Washington than in Kentucky. 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· 13th of 51
$1,950
WA $2,818KY $513
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.