How much rates vary
Facilitymedian $2,754 · 10th to 90th $513 to $5,248Professionalmedian $427 · 10th to 90th $98 to $708
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 $1,348.96 Median $4,365.16 Typical High $9,332.54 | Facility | None | $1,348.96 | $4,365.16 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $457.09 Typical High $524.81 | Professional | None | $97.72 | $457.09 | $524.81 |
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 $371.54 Median $457.09 Typical High $724.44 | Professional | None | $371.54 | $457.09 | $724.44 |
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 $128.82 Median $128.82 Typical High $645.65 | Professional | None | $128.82 | $128.82 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $794.33 Typical High $1,778.28 | Facility | None | $467.74 | $794.33 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $269.15 Typical High $776.25 | Professional | None | $61.66 | $269.15 | $776.25 |
Emblem Health Setting Facility Modifier None Typical Low $85.11 Median $117.49 Typical High $302.00 | Facility | None | $85.11 | $117.49 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $794.33 | Professional | None | $389.05 | $457.09 | $794.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $501.19 | Professional | None | $245.47 | $346.74 | $501.19 |
MVP Health Care Setting Facility Modifier None Typical Low $109.65 Median $3,235.94 Typical High $4,365.16 | Facility | None | $109.65 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $933.25 | Professional | None | $371.54 | $371.54 | $933.25 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,698.24 Typical High $4,897.79 | Facility | None | $549.54 | $1,698.24 | $4,897.79 |
United Setting Professional Modifier None Typical Low $75.86 Median $275.42 Typical High $758.58 | Professional | None | $75.86 | $275.42 | $758.58 |
Univera Setting Facility Modifier None Typical Low $57.54 Median $138.04 Typical High $467.74 | Facility | None | $57.54 | $138.04 | $467.74 |
Univera Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $501.19 | Professional | None | $245.47 | $346.74 | $501.19 |
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 $48.98 Median $229.09 Typical High $263.03 | Professional | 52 · Reduced service | $48.98 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $91.20 Typical High $104.71 | Professional | 53 · Discontinued | $19.50 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $338.84 Typical High $389.05 | Professional | 54 · Surgery only | $72.44 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $67.61 Typical High $77.62 | Professional | 55 · Aftercare only | $14.45 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $45.71 Typical High $52.48 | Professional | 56 · Pre-op care only | $9.77 | $45.71 | $52.48 |
Where New York sits
The same service costs 7.8 times more in Oklahoma 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· 25th of 51
$447
OK $1,148NE $148
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.