How much rates vary
Facilitymedian $2,630 · 10th to 90th $398 to $5,012Professionalmedian $129 · 10th to 90th $102 to $200
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 $1,513.56 Median $4,365.16 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | None | $138.04 | $138.04 | $165.96 |
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 $104.71 Median $123.03 Typical High $186.21 | Professional | None | $104.71 | $123.03 | $186.21 |
CDPHP Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
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 $104.71 Median $104.71 Typical High $245.47 | Professional | None | $104.71 | $104.71 | $245.47 |
Emblem Health Setting Facility Modifier None Typical Low $138.04 Median $229.09 Typical High $478.63 | Facility | None | $138.04 | $229.09 | $478.63 |
Emblem Health Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $239.88 | Professional | None | $117.49 | $134.90 | $239.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $181.97 | Professional | None | $81.28 | $112.20 | $181.97 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,398.83 | Facility | None | $1,230.27 | $1,230.27 | $2,398.83 |
MVP Health Care Setting Facility Modifier None Typical Low $218.78 Median $3,235.94 Typical High $4,365.16 | Facility | None | $218.78 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $239.88 | Professional | None | $194.98 | $194.98 | $239.88 |
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 $87.10 Median $138.04 Typical High $245.47 | Professional | None | $87.10 | $138.04 | $245.47 |
Univera Setting Facility Modifier None Typical Low $87.10 Median $117.49 Typical High $575.44 | Facility | None | $87.10 | $117.49 | $575.44 |
Univera Setting Professional Modifier None Typical Low $81.28 Median $112.20 Typical High $181.97 | Professional | None | $81.28 | $112.20 | $181.97 |
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 $69.18 Median $69.18 Typical High $83.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $33.11 | Professional | 53 · Discontinued | $27.54 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $125.89 | Professional | 54 · Surgery only | $104.71 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $25.12 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $16.60 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $16.60 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $87.10 Typical High $123.03 | Professional | 53 · Discontinued | $66.07 | $87.10 | $123.03 |
Where New York sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 46th of 51
$129
AK $501UT $97.72
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.