How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,000 to $9,550Professionalmedian $112 · 10th to 90th $87 to $229
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 $125.89 Median $125.89 Typical High $416.87 | Professional | None | $125.89 | $125.89 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $109.65 Typical High $199.53 | Professional | None | $93.33 | $109.65 | $199.53 |
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 $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $3,467.37 Typical High $6,760.83 | Facility | None | $954.99 | $3,467.37 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $371.54 | Professional | None | $85.11 | $107.15 | $371.54 |
Emblem Health Setting Facility Modifier None Typical Low $75.86 Median $120.23 Typical High $389.05 | Facility | None | $75.86 | $120.23 | $389.05 |
Emblem Health Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $213.80 | Professional | None | $104.71 | $120.23 | $213.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $169.82 | Professional | None | $79.43 | $97.72 | $169.82 |
MVP Health Care Setting Facility Modifier None Typical Low $128.82 Median $3,235.94 Typical High $4,365.16 | Facility | None | $128.82 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $281.84 | Professional | None | $151.36 | $151.36 | $281.84 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,332.54 | Facility | None | $1,230.27 | $3,162.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $316.23 | Professional | None | $79.43 | $125.89 | $316.23 |
Univera Setting Facility Modifier None Typical Low $85.11 Median $100.00 Typical High $602.56 | Facility | None | $85.11 | $100.00 | $602.56 |
Univera Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $169.82 | Professional | None | $79.43 | $97.72 | $169.82 |
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 $63.10 Median $63.10 Typical High $77.62 | Professional | 52 · Reduced service | $63.10 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $30.90 | Professional | 53 · Discontinued | $25.12 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $93.33 Typical High $117.49 | Professional | 54 · Surgery only | $93.33 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $23.44 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $15.49 |
Where New York sits
The same service costs 12.9 times more in Arkansas than in New York. 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· 51st of 51
$123
AR $1,585NY $123
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.