How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,445 to $11,749Professionalmedian $1,288 · 10th to 90th $309 to $2,399
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 $1,584.89 Median $5,248.07 Typical High $11,748.98 | Facility | None | $1,584.89 | $5,248.07 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $1,412.54 Typical High $1,819.70 | Professional | None | $316.23 | $1,412.54 | $1,819.70 |
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 $1,122.02 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,318.26 | $1,949.84 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $12,302.69 | Facility | None | $1,584.89 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $1,995.26 | Professional | None | $363.08 | $363.08 | $1,995.26 |
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 $245.47 Median $707.95 Typical High $2,238.72 | Professional | None | $245.47 | $707.95 | $2,238.72 |
Emblem Health Setting Facility Modifier None Typical Low $269.15 Median $407.38 Typical High $870.96 | Facility | None | $269.15 | $407.38 | $870.96 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,479.11 | $2,137.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,698.24 | Professional | None | $776.25 | $1,096.48 | $1,698.24 |
Highmark BCBS Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Highmark BCBS Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $2,290.87 | Professional | None | $316.23 | $316.23 | $2,290.87 |
MVP Health Care Setting Facility Modifier None Typical Low $1,230.27 Median $3,235.94 Typical High $4,365.16 | Facility | None | $1,230.27 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $2,089.30 Median $3,090.30 Typical High $3,548.13 | Professional | None | $2,089.30 | $3,090.30 | $3,548.13 |
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 $239.88 Median $933.25 Typical High $2,238.72 | Professional | None | $239.88 | $933.25 | $2,238.72 |
Univera Setting Facility Modifier None Typical Low $177.83 Median $323.59 Typical High $812.83 | Facility | None | $177.83 | $323.59 | $812.83 |
Univera Setting Professional Modifier None Typical Low $741.31 Median $1,174.90 Typical High $1,698.24 | Professional | None | $741.31 | $1,174.90 | $1,698.24 |
6 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 $158.49 Median $616.60 Typical High $831.76 | Professional | 52 · Reduced service | $158.49 | $616.60 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $245.47 Typical High $331.13 | Professional | 53 · Discontinued | $63.10 | $245.47 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $933.25 Typical High $1,230.27 | Professional | 54 · Surgery only | $234.42 | $933.25 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $186.21 Typical High $245.47 | Professional | 55 · Aftercare only | $46.77 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $123.03 Typical High $165.96 | Professional | 56 · Pre-op care only | $31.62 | $123.03 | $165.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $912.01 Typical High $1,258.93 | Professional | 53 · Discontinued | $724.44 | $912.01 | $1,258.93 |
Where New York sits
The same service costs 4.7 times more in Wisconsin than in Nebraska. 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· 23rd of 51
$1,288
WI $2,089NE $447
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.