How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,023 to $11,220Professionalmedian $191 · 10th to 90th $151 to $398
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 $1,000.00 Median $5,248.07 Typical High $9,772.37 | Facility | None | $1,000.00 | $5,248.07 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $645.65 | Professional | None | $199.53 | $199.53 | $645.65 |
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 $162.18 Median $190.55 Typical High $363.08 | Professional | None | $162.18 | $190.55 | $363.08 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,148.15 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,862.09 | $3,981.07 | $8,128.31 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $776.25 | Professional | None | $158.49 | $263.03 | $776.25 |
Emblem Health Setting Facility Modifier None Typical Low $169.82 Median $208.93 Typical High $645.65 | Facility | None | $169.82 | $208.93 | $645.65 |
Emblem Health Setting Professional Modifier None Typical Low $177.83 Median $194.98 Typical High $316.23 | Professional | None | $177.83 | $194.98 | $316.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $229.09 | Professional | None | $125.89 | $151.36 | $229.09 |
MVP Health Care Setting Facility Modifier None Typical Low $151.36 Median $3,235.94 Typical High $4,365.16 | Facility | None | $151.36 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $467.74 | Professional | None | $257.04 | $257.04 | $467.74 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,318.26 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $128.82 Median $229.09 Typical High $549.54 | Professional | None | $128.82 | $229.09 | $549.54 |
Univera Setting Facility Modifier None Typical Low $97.72 Median $177.83 Typical High $363.08 | Facility | None | $97.72 | $177.83 | $363.08 |
Univera Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $229.09 | Professional | None | $125.89 | $151.36 | $229.09 |
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 $100.00 Median $100.00 Typical High $107.15 | Professional | 52 · Reduced service | $100.00 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $42.66 | Professional | 53 · Discontinued | $39.81 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $162.18 | Professional | 54 · Surgery only | $151.36 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $32.36 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $21.38 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $21.38 |
Where New York sits
The same service costs 10.2 times more in Oklahoma 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· 49th of 51
$200
OK $1,950KY $191
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.