How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,698 to $12,882Professionalmedian $1,995 · 10th to 90th $407 to $3,715
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 $1,819.70 Median $5,370.32 Typical High $12,302.69 | Facility | None | $1,819.70 | $5,370.32 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $2,041.74 Typical High $2,818.38 | Professional | None | $407.38 | $2,041.74 | $2,818.38 |
Ambetter Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
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 $1,778.28 Median $2,089.30 Typical High $3,019.95 | Professional | None | $1,778.28 | $2,089.30 | $3,019.95 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $4,073.80 Typical High $12,302.69 | Facility | None | $1,905.46 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $3,090.30 | Professional | None | $501.19 | $501.19 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $933.25 Typical High $3,548.13 | Professional | None | $323.59 | $933.25 | $3,548.13 |
Emblem Health Setting Facility Modifier None Typical Low $354.81 Median $562.34 Typical High $1,174.90 | Facility | None | $354.81 | $562.34 | $1,174.90 |
Emblem Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $3,311.31 | Professional | None | $2,041.74 | $2,290.87 | $3,311.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,819.70 | $2,818.38 |
Highmark BCBS Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
MVP Health Care Setting Facility Modifier None Typical Low $1,862.09 Median $3,235.94 Typical High $4,365.16 | Facility | None | $1,862.09 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $3,311.31 Median $4,677.35 Typical High $5,495.41 | Professional | None | $3,311.31 | $4,677.35 | $5,495.41 |
United Setting Facility Modifier None Typical Low $2,454.71 Median $6,760.83 Typical High $16,595.87 | Facility | None | $2,454.71 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $323.59 Median $1,412.54 Typical High $3,467.37 | Professional | None | $323.59 | $1,412.54 | $3,467.37 |
Univera Setting Facility Modifier None Typical Low $251.19 Median $457.09 Typical High $1,071.52 | Facility | None | $251.19 | $457.09 | $1,071.52 |
Univera Setting Professional Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,819.70 | $2,818.38 |
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 $204.17 Median $933.25 Typical High $1,258.93 | Professional | 52 · Reduced service | $204.17 | $933.25 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $371.54 Typical High $501.19 | Professional | 53 · Discontinued | $81.28 | $371.54 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $1,412.54 Typical High $1,905.46 | Professional | 54 · Surgery only | $309.03 | $1,412.54 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $275.42 Typical High $380.19 | Professional | 55 · Aftercare only | $61.66 | $275.42 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $186.21 Typical High $251.19 | Professional | 56 · Pre-op care only | $40.74 | $186.21 | $251.19 |
Where New York sits
The same service costs 6.9 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· 21st of 51
$2,042
WI $3,162HI $457
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.