How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,445 to $11,749Professionalmedian $1,202 · 10th to 90th $331 to $2,239
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 $1,513.56 Median $5,248.07 Typical High $11,748.98 | Facility | None | $1,513.56 | $5,248.07 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $1,318.26 Typical High $1,659.59 | Professional | None | $331.13 | $1,318.26 | $1,659.59 |
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 $1,071.52 Median $1,258.93 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,905.46 Typical High $2,630.27 | Professional | 50 · Both sides | $1,621.81 | $1,905.46 | $2,630.27 |
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 $398.11 Median $398.11 Typical High $1,819.70 | Professional | None | $398.11 | $398.11 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Facility | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $758.58 Typical High $2,187.76 | Professional | None | $288.40 | $758.58 | $2,187.76 |
Emblem Health Setting Facility Modifier None Typical Low $309.03 Median $416.87 Typical High $1,000.00 | Facility | None | $309.03 | $416.87 | $1,000.00 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,513.56 | $2,187.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,659.59 | Professional | None | $794.33 | $1,071.52 | $1,659.59 |
MVP Health Care Setting Facility Modifier None Typical Low $331.13 Median $3,235.94 Typical High $4,365.16 | Facility | None | $331.13 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,905.46 | $2,344.23 | $3,162.28 |
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 $269.15 Median $954.99 Typical High $2,089.30 | Professional | None | $269.15 | $954.99 | $2,089.30 |
Univera Setting Facility Modifier None Typical Low $199.53 Median $363.08 Typical High $741.31 | Facility | None | $199.53 | $363.08 | $741.31 |
Univera Setting Professional Modifier None Typical Low $724.44 Median $1,148.15 Typical High $1,621.81 | Professional | None | $724.44 | $1,148.15 | $1,621.81 |
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 $165.96 Median $602.56 Typical High $812.83 | Professional | 52 · Reduced service | $165.96 | $602.56 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $239.88 Typical High $323.59 | Professional | 53 · Discontinued | $66.07 | $239.88 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $891.25 Typical High $1,202.26 | Professional | 54 · Surgery only | $245.47 | $891.25 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $177.83 Typical High $239.88 | Professional | 55 · Aftercare only | $48.98 | $177.83 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $120.23 Typical High $162.18 | Professional | 56 · Pre-op care only | $33.11 | $120.23 | $162.18 |
Where New York sits
The same service costs 5.1 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· 22nd of 51
$1,230
WI $2,042MD $398
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.