How much rates vary
Facilitymedian $5,129 · 10th to 90th $794 to $11,749Professionalmedian $891 · 10th to 90th $275 to $1,349
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 $331.13 Median $3,981.07 Typical High $11,748.98 | Facility | None | $331.13 | $3,981.07 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $912.01 Typical High $1,288.25 | Professional | None | $302.00 | $912.01 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,365.16 Median $7,762.47 Typical High $12,882.50 | Facility | None | $4,365.16 | $7,762.47 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,230.27 | Professional | None | $831.76 | $977.24 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,479.11 Typical High $1,819.70 | Professional | 50 · Both sides | $1,258.93 | $1,479.11 | $1,819.70 |
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 $354.81 Median $354.81 Typical High $1,258.93 | Professional | None | $354.81 | $354.81 | $1,258.93 |
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 $251.19 Median $676.08 Typical High $1,584.89 | Professional | None | $251.19 | $676.08 | $1,584.89 |
Emblem Health Setting Facility Modifier None Typical Low $181.97 Median $275.42 Typical High $870.96 | Facility | None | $181.97 | $275.42 | $870.96 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,412.54 | Professional | None | $870.96 | $954.99 | $1,412.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,071.52 | Professional | None | $524.81 | $758.58 | $1,071.52 |
Highmark BCBS Setting Facility Modifier None Typical Low $478.63 Median $2,290.87 Typical High $8,317.64 | Facility | None | $478.63 | $2,290.87 | $8,317.64 |
Highmark BCBS Setting Professional Modifier None Typical Low $229.09 Median $588.84 Typical High $1,380.38 | Professional | None | $229.09 | $588.84 | $1,380.38 |
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 $275.42 Median $275.42 Typical High $2,187.76 | Professional | None | $275.42 | $275.42 | $2,187.76 |
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 $239.88 Median $660.69 Typical High $1,513.56 | Professional | None | $239.88 | $660.69 | $1,513.56 |
Univera Setting Facility Modifier None Typical Low $173.78 Median $316.23 Typical High $1,445.44 | Facility | None | $173.78 | $316.23 | $1,445.44 |
Univera Setting Professional Modifier None Typical Low $524.81 Median $831.76 Typical High $1,023.29 | Professional | None | $524.81 | $831.76 | $1,023.29 |
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 $147.91 Median $457.09 Typical High $588.84 | Professional | 52 · Reduced service | $147.91 | $457.09 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $181.97 Typical High $234.42 | Professional | 53 · Discontinued | $60.26 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $691.83 Typical High $870.96 | Professional | 54 · Surgery only | $223.87 | $691.83 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $138.04 Typical High $173.78 | Professional | 55 · Aftercare only | $44.67 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $91.20 Typical High $117.49 | Professional | 56 · Pre-op care only | $30.20 | $91.20 | $117.49 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $1,174.90 Median $1,380.38 Typical High $1,412.54 | Professional | GL · Free upgrade | $1,174.90 | $1,380.38 | $1,412.54 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $575.44 Typical High $812.83 | Professional | 53 · Discontinued | $446.68 | $575.44 | $812.83 |
Where New York sits
The same service costs 4.3 times more in Wisconsin than in Hawaii. 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
$912
WI $1,380HI $324
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.