How much rates vary
Facilitymedian $2,630 · 10th to 90th $355 to $5,012Professionalmedian $49 · 10th to 90th $38 to $74
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 $1,096.48 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,096.48 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $69.18 | Professional | None | $60.26 | $60.26 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $67.61 | Professional | None | $39.81 | $47.86 | $67.61 |
CDPHP Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $562.34 Typical High $1,479.11 | Facility | None | $331.13 | $562.34 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $39.81 Typical High $102.33 | Professional | None | $38.02 | $39.81 | $102.33 |
Emblem Health Setting Facility Modifier None Typical Low $46.77 Median $93.33 Typical High $181.97 | Facility | None | $46.77 | $93.33 | $181.97 |
Emblem Health Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $81.28 | Professional | None | $44.67 | $48.98 | $81.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $33.11 Median $40.74 Typical High $69.18 | Professional | None | $33.11 | $40.74 | $69.18 |
MVP Health Care Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
MVP Health Care Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $102.33 | Professional | None | $64.57 | $64.57 | $102.33 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,258.93 Typical High $4,365.16 | Facility | None | $363.08 | $1,258.93 | $4,365.16 |
United Setting Professional Modifier None Typical Low $31.62 Median $53.70 Typical High $89.13 | Professional | None | $31.62 | $53.70 | $89.13 |
Univera Setting Facility Modifier None Typical Low $35.48 Median $44.67 Typical High $223.87 | Facility | None | $35.48 | $44.67 | $223.87 |
Univera Setting Professional Modifier None Typical Low $33.11 Median $40.74 Typical High $69.18 | Professional | None | $33.11 | $40.74 | $69.18 |
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 $30.20 Median $30.20 Typical High $34.67 | Professional | 52 · Reduced service | $30.20 | $30.20 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $13.80 | Professional | 53 · Discontinued | $12.30 | $12.30 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $45.71 Typical High $51.29 | Professional | 54 · Surgery only | $45.71 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $10.23 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.92 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $33.88 Typical High $48.98 | Professional | 53 · Discontinued | $26.92 | $33.88 | $48.98 |
Where New York sits
The same service costs 4.2 times more in Alaska 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· 50th of 51
$50.12
AK $200FL $47.86
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.