How much rates vary
Facilitymedian $5,370 · 10th to 90th $209 to $11,749Professionalmedian $126 · 10th to 90th $54 to $204
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 $162.18 Median $4,365.16 Typical High $10,964.78 | Facility | None | $162.18 | $4,365.16 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $134.90 Typical High $181.97 | Professional | None | $53.70 | $134.90 | $181.97 |
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 $112.20 Median $131.83 Typical High $181.97 | Professional | None | $112.20 | $131.83 | $181.97 |
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 $69.18 Median $69.18 Typical High $186.21 | Professional | None | $69.18 | $69.18 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $112.20 Typical High $251.19 | Professional | None | $43.65 | $112.20 | $251.19 |
Emblem Health Setting Facility Modifier None Typical Low $39.81 Median $52.48 Typical High $158.49 | Facility | None | $39.81 | $52.48 | $158.49 |
Emblem Health Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $199.53 | Professional | None | $120.23 | $134.90 | $199.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $75.86 Median $107.15 Typical High $158.49 | Professional | None | $75.86 | $107.15 | $158.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $478.63 Median $707.95 Typical High $10,964.78 | Facility | None | $478.63 | $707.95 | $10,964.78 |
Highmark BCBS Setting Professional Modifier None Typical Low $60.26 Median $79.43 Typical High $204.17 | Professional | None | $60.26 | $79.43 | $204.17 |
MVP Health Care Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
MVP Health Care Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $338.84 | Professional | None | $54.95 | $54.95 | $338.84 |
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 $44.67 Median $102.33 Typical High $239.88 | Professional | None | $44.67 | $102.33 | $239.88 |
Univera Setting Facility Modifier None Typical Low $33.88 Median $61.66 Typical High $234.42 | Facility | None | $33.88 | $61.66 | $234.42 |
Univera Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $158.49 | Professional | None | $75.86 | $112.20 | $158.49 |
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 $26.92 Median $67.61 Typical High $83.18 | Professional | 52 · Reduced service | $26.92 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $27.54 Typical High $33.11 | Professional | 53 · Discontinued | $10.72 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $102.33 Typical High $123.03 | Professional | 54 · Surgery only | $39.81 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $20.42 Typical High $24.55 | Professional | 55 · Aftercare only | $8.13 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $14.13 Typical High $16.60 | Professional | 56 · Pre-op care only | $5.37 | $14.13 | $16.60 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $165.96 Median $194.98 Typical High $194.98 | Professional | GL · Free upgrade | $165.96 | $194.98 | $194.98 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $89.13 Typical High $120.23 | Professional | 53 · Discontinued | $70.79 | $89.13 | $120.23 |
Where New York sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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
$126
WI $234FL $85.11
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.