How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,096 to $10,965Professionalmedian $1,148 · 10th to 90th $263 to $1,995
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 $1,348.96 Median $4,365.16 Typical High $11,481.54 | Facility | None | $1,348.96 | $4,365.16 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $1,202.26 Typical High $1,737.80 | Professional | None | $263.03 | $1,202.26 | $1,737.80 |
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 $977.24 Median $1,148.15 Typical High $1,905.46 | Professional | None | $977.24 | $1,148.15 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,737.80 Typical High $2,754.23 | Professional | 50 · Both sides | $1,479.11 | $1,737.80 | $2,754.23 |
CDPHP Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $10,964.78 | Facility | None | $3,630.78 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $1,905.46 | Professional | None | $338.84 | $338.84 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $691.83 Typical High $2,137.96 | Professional | None | $234.42 | $691.83 | $2,137.96 |
Emblem Health Setting Facility Modifier None Typical Low $263.03 Median $316.23 Typical High $912.01 | Facility | None | $263.03 | $316.23 | $912.01 |
Emblem Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,698.24 | $1,862.09 | $2,691.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $1,862.09 | Professional | None | $851.14 | $1,230.27 | $1,862.09 |
MVP Health Care Setting Facility Modifier None Typical Low $251.19 Median $6,606.93 Typical High $53,703.18 | Facility | None | $251.19 | $6,606.93 | $53,703.18 |
MVP Health Care Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,311.31 | Professional | None | $1,949.84 | $1,949.84 | $3,311.31 |
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 $234.42 Median $1,096.48 Typical High $2,187.76 | Professional | None | $234.42 | $1,096.48 | $2,187.76 |
Univera Setting Facility Modifier None Typical Low $173.78 Median $316.23 Typical High $562.34 | Facility | None | $173.78 | $316.23 | $562.34 |
Univera Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $1,778.28 | Professional | None | $851.14 | $1,230.27 | $1,778.28 |
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 $131.83 Median $602.56 Typical High $741.31 | Professional | 52 · Reduced service | $131.83 | $602.56 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $239.88 Typical High $295.12 | Professional | 53 · Discontinued | $52.48 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $891.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $194.98 | $891.25 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $177.83 Typical High $218.78 | Professional | 55 · Aftercare only | $38.90 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $120.23 Typical High $147.91 | Professional | 56 · Pre-op care only | $26.30 | $120.23 | $147.91 |
Where New York sits
The same service costs 6.5 times more in Washington 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· 30th of 51
$1,148
WA $2,138MD $331
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.