How much rates vary
Facilitymedian $2,818 · 10th to 90th $525 to $5,370Professionalmedian $209 · 10th to 90th $123 to $427
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 $1,479.11 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,479.11 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $223.87 Typical High $316.23 | Professional | None | $117.49 | $223.87 | $316.23 |
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 $173.78 Median $208.93 Typical High $407.38 | Professional | None | $173.78 | $208.93 | $407.38 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $346.74 | Professional | None | $154.88 | $154.88 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,412.54 Typical High $2,238.72 | Facility | None | $794.33 | $1,412.54 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $194.98 Typical High $524.81 | Professional | None | $93.33 | $194.98 | $524.81 |
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 $281.84 Median $323.59 Typical High $537.03 | Professional | None | $281.84 | $323.59 | $537.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $316.23 | Professional | None | $120.23 | $218.78 | $316.23 |
MVP Health Care Setting Facility Modifier None Typical Low $107.15 Median $3,235.94 Typical High $4,365.16 | Facility | None | $107.15 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $602.56 | Professional | None | $199.53 | $199.53 | $602.56 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $4,897.79 | Facility | None | $549.54 | $1,862.09 | $4,897.79 |
United Setting Professional Modifier None Typical Low $100.00 Median $218.78 Typical High $478.63 | Professional | None | $100.00 | $218.78 | $478.63 |
Univera Setting Facility Modifier None Typical Low $77.62 Median $218.78 Typical High $331.13 | Facility | None | $77.62 | $218.78 | $331.13 |
Univera Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $316.23 | Professional | None | $120.23 | $218.78 | $316.23 |
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 $58.88 Median $109.65 Typical High $158.49 | Professional | 52 · Reduced service | $58.88 | $109.65 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $44.67 Typical High $63.10 | Professional | 53 · Discontinued | $23.44 | $44.67 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $165.96 Typical High $239.88 | Professional | 54 · Surgery only | $87.10 | $165.96 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $33.11 Typical High $47.86 | Professional | 55 · Aftercare only | $17.38 | $33.11 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $22.39 Typical High $31.62 | Professional | 56 · Pre-op care only | $11.75 | $22.39 | $31.62 |
Where New York sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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
$224
AK $776KY $182
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.