How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,148 to $11,749Professionalmedian $138 · 10th to 90th $107 to $275
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $524.81 | Professional | None | $165.96 | $165.96 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $131.83 Typical High $251.19 | Professional | None | $109.65 | $131.83 | $251.19 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $5,248.07 Typical High $10,471.29 | Facility | None | $1,318.26 | $5,248.07 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $457.09 | Professional | None | $114.82 | $131.83 | $457.09 |
Emblem Health Setting Facility Modifier None Typical Low $151.36 Median $281.84 Typical High $575.44 | Facility | None | $151.36 | $281.84 | $575.44 |
Emblem Health Setting Professional Modifier None Typical Low $138.04 Median $158.49 Typical High $275.42 | Professional | None | $138.04 | $158.49 | $275.42 |
Excellus BCBS Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $190.55 | Professional | None | $89.13 | $120.23 | $190.55 |
MVP Health Care Setting Facility Modifier None Typical Low $269.15 Median $3,235.94 Typical High $4,365.16 | Facility | None | $269.15 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $346.74 | Professional | None | $218.78 | $218.78 | $346.74 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $13,182.57 | Facility | None | $1,318.26 | $4,073.80 | $13,182.57 |
United Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $407.38 | Professional | None | $104.71 | $158.49 | $407.38 |
Univera Setting Facility Modifier None Typical Low $93.33 Median $125.89 Typical High $977.24 | Facility | None | $93.33 | $125.89 | $977.24 |
Univera Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $181.97 | Professional | None | $89.13 | $125.89 | $181.97 |
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 $81.28 Median $81.28 Typical High $89.13 | Professional | 52 · Reduced service | $81.28 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $35.48 | Professional | 53 · Discontinued | $33.11 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $123.03 Typical High $134.90 | Professional | 54 · Surgery only | $123.03 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $26.92 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $17.78 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $17.78 |
Where New York sits
The same service costs 17.8 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
$145
AR $2,570NY $145
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.