How much rates vary
Facilitymedian $2,754 · 10th to 90th $355 to $5,012Professionalmedian $78 · 10th to 90th $58 to $162
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 $645.65 Median $5,888.44 Typical High $10,964.78 | Facility | None | $645.65 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $95.50 Typical High $158.49 | Professional | None | $58.88 | $95.50 | $158.49 |
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 $63.10 Median $77.62 Typical High $147.91 | Professional | None | $63.10 | $77.62 | $147.91 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $117.49 | Professional | None | $75.86 | $75.86 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $1,778.28 Typical High $1,949.84 | Facility | None | $81.28 | $1,778.28 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $64.57 Typical High $186.21 | Professional | None | $39.81 | $64.57 | $186.21 |
Emblem Health Setting Facility Modifier None Typical Low $51.29 Median $104.71 Typical High $194.98 | Facility | None | $51.29 | $104.71 | $194.98 |
Emblem Health Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $186.21 | Professional | None | $91.20 | $104.71 | $186.21 |
Excellus BCBS Setting Professional Modifier None Typical Low $57.54 Median $83.18 Typical High $120.23 | Professional | None | $57.54 | $83.18 | $120.23 |
MVP Health Care Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
MVP Health Care Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $213.80 | Professional | None | $67.61 | $67.61 | $213.80 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $46.77 Median $83.18 Typical High $190.55 | Professional | None | $46.77 | $83.18 | $190.55 |
Univera Setting Facility Modifier None Typical Low $38.02 Median $87.10 Typical High $263.03 | Facility | None | $38.02 | $87.10 | $263.03 |
Univera Setting Professional Modifier None Typical Low $57.54 Median $87.10 Typical High $120.23 | Professional | None | $57.54 | $87.10 | $120.23 |
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 $29.51 Median $47.86 Typical High $57.54 | Professional | 52 · Reduced service | $29.51 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $19.05 Typical High $23.44 | Professional | 53 · Discontinued | $11.75 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $72.44 Typical High $87.10 | Professional | 54 · Surgery only | $43.65 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $14.45 Typical High $17.38 | Professional | 55 · Aftercare only | $8.71 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $9.55 Typical High $11.48 | Professional | 56 · Pre-op care only | $5.89 | $9.55 | $11.48 |
Where New York sits
The same service costs 3.7 times more in Wisconsin 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
$81.28
WI $282FL $75.86
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.