How much rates vary
Facilitymedian $3,162 · 10th to 90th $550 to $7,413Professionalmedian $200 · 10th to 90th $115 to $437
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 $436.52 Median $4,265.80 Typical High $9,120.11 | Facility | None | $436.52 | $4,265.80 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $263.03 Typical High $354.81 | Professional | None | $123.03 | $263.03 | $354.81 |
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 $165.96 Median $199.53 Typical High $346.74 | Professional | None | $165.96 | $199.53 | $346.74 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $281.84 | Professional | None | $120.23 | $120.23 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,754.23 Typical High $5,370.32 | Facility | None | $1,000.00 | $2,754.23 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $147.91 Typical High $407.38 | Professional | None | $63.10 | $147.91 | $407.38 |
Emblem Health Setting Facility Modifier None Typical Low $89.13 Median $169.82 Typical High $346.74 | Facility | None | $89.13 | $169.82 | $346.74 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $436.52 | Professional | None | $229.09 | $263.03 | $436.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $257.04 | Professional | None | $123.03 | $199.53 | $257.04 |
MVP Health Care Setting Facility Modifier None Typical Low $154.88 Median $3,235.94 Typical High $4,365.16 | Facility | None | $154.88 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $478.63 | Professional | None | $457.09 | $478.63 | $478.63 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $5,248.07 | Facility | None | $549.54 | $1,862.09 | $5,248.07 |
United Setting Professional Modifier None Typical Low $74.13 Median $173.78 Typical High $407.38 | Professional | None | $74.13 | $173.78 | $407.38 |
Univera Setting Facility Modifier None Typical Low $60.26 Median $177.83 Typical High $933.25 | Facility | None | $60.26 | $177.83 | $933.25 |
Univera Setting Professional Modifier None Typical Low $123.03 Median $199.53 Typical High $257.04 | Professional | None | $123.03 | $199.53 | $257.04 |
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 $61.66 Median $131.83 Typical High $138.04 | Professional | 52 · Reduced service | $61.66 | $131.83 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $52.48 Typical High $54.95 | Professional | 53 · Discontinued | $24.55 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $194.98 Typical High $204.17 | Professional | 54 · Surgery only | $93.33 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $39.81 Typical High $40.74 | Professional | 55 · Aftercare only | $18.62 | $39.81 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $26.30 Typical High $27.54 | Professional | 56 · Pre-op care only | $12.30 | $26.30 | $27.54 |
Where New York sits
The same service costs 4.1 times more in Alaska 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· 47th of 51
$204
AK $646NE $158
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.