How much rates vary
Facilitymedian $3,311 · 10th to 90th $851 to $7,586Professionalmedian $1,479 · 10th to 90th $170 to $2,692
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 $4,897.79 Typical High $9,120.11 | Facility | None | $1,819.70 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $1,737.80 Typical High $2,089.30 | Professional | None | $165.96 | $1,737.80 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,584.89 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,344.23 Typical High $4,168.69 | Professional | 50 · Both sides | $1,949.84 | $2,344.23 | $4,168.69 |
CDPHP Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $13,489.63 | Facility | None | $4,466.84 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $2,344.23 | Professional | None | $213.80 | $213.80 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $3,890.45 | Facility | None | $1,318.26 | $1,905.46 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $524.81 Typical High $2,884.03 | Professional | None | $125.89 | $524.81 | $2,884.03 |
Emblem Health Setting Facility Modifier None Typical Low $154.88 Median $208.93 Typical High $549.54 | Facility | None | $154.88 | $208.93 | $549.54 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,380.38 | $1,659.59 | $2,754.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,819.70 | Professional | None | $851.14 | $1,258.93 | $1,819.70 |
Fidelis Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Professional | None | $1,258.93 | $1,258.93 | $1,445.44 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
MVP Health Care Setting Facility Modifier None Typical Low $181.97 Median $3,235.94 Typical High $4,365.16 | Facility | None | $181.97 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $3,548.13 | Professional | None | $1,513.56 | $1,513.56 | $3,548.13 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $6,309.57 | Facility | None | $851.14 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $138.04 Median $954.99 Typical High $2,951.21 | Professional | None | $138.04 | $954.99 | $2,951.21 |
Univera Setting Facility Modifier None Typical Low $107.15 Median $234.42 Typical High $1,659.59 | Facility | None | $107.15 | $234.42 | $1,659.59 |
Univera Setting Professional Modifier None Typical Low $851.14 Median $1,258.93 Typical High $1,778.28 | Professional | None | $851.14 | $1,258.93 | $1,778.28 |
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 $83.18 Median $891.25 Typical High $1,023.29 | Professional | 52 · Reduced service | $83.18 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $354.81 Typical High $407.38 | Professional | 53 · Discontinued | $33.11 | $354.81 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $1,348.96 Typical High $1,513.56 | Professional | 54 · Surgery only | $125.89 | $1,348.96 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $269.15 Typical High $309.03 | Professional | 55 · Aftercare only | $25.12 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $177.83 Typical High $204.17 | Professional | 56 · Pre-op care only | $16.60 | $177.83 | $204.17 |
Where New York sits
The same service costs 8.5 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· 18th of 51
$1,514
WI $2,291NE $269
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.