How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,096 to $11,749Professionalmedian $138 · 10th to 90th $107 to $282
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 $147.91 Median $147.91 Typical High $489.78 | Professional | None | $147.91 | $147.91 | $489.78 |
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 $112.20 Median $134.90 Typical High $263.03 | Professional | None | $112.20 | $134.90 | $263.03 |
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 $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
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 $117.49 Median $134.90 Typical High $467.74 | Professional | None | $117.49 | $134.90 | $467.74 |
Emblem Health Setting Facility Modifier None Typical Low $134.90 Median $165.96 Typical High $512.86 | Facility | None | $134.90 | $165.96 | $512.86 |
Emblem Health Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $281.84 | Professional | None | $125.89 | $158.49 | $281.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $194.98 | Professional | None | $91.20 | $117.49 | $194.98 |
MVP Health Care Setting Facility Modifier None Typical Low $165.96 Median $3,235.94 Typical High $4,365.16 | Facility | None | $165.96 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $363.08 | Professional | None | $245.47 | $245.47 | $363.08 |
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 $162.18 Typical High $416.87 | Professional | None | $104.71 | $162.18 | $416.87 |
Univera Setting Facility Modifier None Typical Low $97.72 Median $128.82 Typical High $371.54 | Facility | None | $97.72 | $128.82 | $371.54 |
Univera Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $194.98 | Professional | None | $91.20 | $117.49 | $194.98 |
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 $74.13 Median $74.13 Typical High $93.33 | Professional | 52 · Reduced service | $74.13 | $74.13 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $37.15 | Professional | 53 · Discontinued | $29.51 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $138.04 | Professional | 54 · Surgery only | $109.65 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $27.54 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $18.62 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $18.62 |
Where New York sits
The same service costs 20.4 times more in Kansas 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
$148
KS $3,020NY $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.