How much rates vary
Facilitymedian $3,162 · 10th to 90th $692 to $7,413Professionalmedian $692 · 10th to 90th $162 to $1,000
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 $645.65 Median $3,981.07 Typical High $9,332.54 | Facility | None | $645.65 | $3,981.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $549.54 Typical High $977.24 | Professional | None | $158.49 | $549.54 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $676.08 | Professional | None | $144.54 | $162.18 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $954.99 | Professional | None | $660.69 | $776.25 | $954.99 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $5,495.41 Typical High $16,595.87 | Facility | None | $1,905.46 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $1,047.13 | Professional | None | $234.42 | $234.42 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $1,047.13 Typical High $1,905.46 | Facility | None | $363.08 | $1,047.13 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $398.11 Typical High $1,023.29 | Professional | None | $131.83 | $398.11 | $1,023.29 |
Emblem Health Setting Facility Modifier None Typical Low $158.49 Median $199.53 Typical High $602.56 | Facility | None | $158.49 | $199.53 | $602.56 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,202.26 | Professional | None | $741.31 | $831.76 | $1,202.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $912.01 | Professional | None | $426.58 | $616.60 | $912.01 |
Highmark BCBS Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $446.68 | Facility | None | $87.10 | $87.10 | $446.68 |
Highmark BCBS Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $616.60 | Professional | None | $204.17 | $204.17 | $616.60 |
MVP Health Care Setting Facility Modifier None Typical Low $173.78 Median $3,235.94 Typical High $4,365.16 | Facility | None | $173.78 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,737.80 | Professional | None | $512.86 | $512.86 | $1,737.80 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,165.95 | Facility | None | $831.76 | $2,290.87 | $6,165.95 |
United Setting Professional Modifier None Typical Low $151.36 Median $512.86 Typical High $1,122.02 | Professional | None | $151.36 | $512.86 | $1,122.02 |
Univera Setting Facility Modifier None Typical Low $117.49 Median $245.47 Typical High $870.96 | Facility | None | $117.49 | $245.47 | $870.96 |
Univera Setting Professional Modifier None Typical Low $426.58 Median $660.69 Typical High $870.96 | Professional | None | $426.58 | $660.69 | $870.96 |
6 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 $79.43 Median $309.03 Typical High $407.38 | Professional | 52 · Reduced service | $79.43 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $123.03 Typical High $162.18 | Professional | 53 · Discontinued | $31.62 | $123.03 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $467.74 Typical High $616.60 | Professional | 54 · Surgery only | $117.49 | $467.74 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $93.33 Typical High $123.03 | Professional | 55 · Aftercare only | $23.99 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $61.66 Typical High $81.28 | Professional | 56 · Pre-op care only | $15.85 | $61.66 | $81.28 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $446.68 Typical High $616.60 | Professional | 53 · Discontinued | $354.81 | $446.68 | $616.60 |
Where New York sits
The same service costs 5.2 times more in Wisconsin than in Hawaii. 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· 15th of 51
$692
WI $1,148HI $219
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.