How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,445 to $11,749Professionalmedian $891 · 10th to 90th $240 to $1,820
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 $1,659.59 Median $5,370.32 Typical High $11,748.98 | Facility | None | $1,659.59 | $5,370.32 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $1,071.52 Typical High $1,380.38 | Professional | None | $239.88 | $1,071.52 | $1,380.38 |
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 $758.58 Median $891.25 Typical High $1,479.11 | Professional | None | $758.58 | $891.25 | $1,479.11 |
CDPHP Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $12,302.69 | Facility | None | $4,073.80 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $1,513.56 | Professional | None | $281.84 | $281.84 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $562.34 Typical High $1,659.59 | Professional | None | $204.17 | $562.34 | $1,659.59 |
Emblem Health Setting Facility Modifier None Typical Low $213.80 Median $309.03 Typical High $691.83 | Facility | None | $213.80 | $309.03 | $691.83 |
Emblem Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,148.15 | $1,659.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,380.38 | Professional | None | $616.60 | $912.01 | $1,380.38 |
MVP Health Care Setting Facility Modifier None Typical Low $245.47 Median $3,235.94 Typical High $4,365.16 | Facility | None | $245.47 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,584.89 | $1,905.46 | $2,630.27 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,128.61 Typical High $11,481.54 | Facility | None | $2,398.83 | $5,128.61 | $11,481.54 |
United Setting Professional Modifier None Typical Low $190.55 Median $691.83 Typical High $1,659.59 | Professional | None | $190.55 | $691.83 | $1,659.59 |
Univera Setting Facility Modifier None Typical Low $138.04 Median $251.19 Typical High $537.03 | Facility | None | $138.04 | $251.19 | $537.03 |
Univera Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,380.38 | Professional | None | $616.60 | $912.01 | $1,380.38 |
5 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 $120.23 Median $489.78 Typical High $645.65 | Professional | 52 · Reduced service | $120.23 | $489.78 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $194.98 Typical High $263.03 | Professional | 53 · Discontinued | $47.86 | $194.98 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $724.44 Typical High $977.24 | Professional | 54 · Surgery only | $181.97 | $724.44 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $144.54 Typical High $194.98 | Professional | 55 · Aftercare only | $36.31 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $97.72 Typical High $131.83 | Professional | 56 · Pre-op care only | $23.99 | $97.72 | $131.83 |
Where New York sits
The same service costs 5.9 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· 33rd of 51
$891
WI $1,622MD $275
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.