How much rates vary
Facilitymedian $2,570 · 10th to 90th $151 to $5,012Professionalmedian $91 · 10th to 90th $37 to $195
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 $131.83 Median $3,890.45 Typical High $8,128.31 | Facility | None | $131.83 | $3,890.45 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $104.71 Typical High $169.82 | Professional | None | $33.88 | $104.71 | $169.82 |
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 $81.28 Median $97.72 Typical High $194.98 | Professional | None | $81.28 | $97.72 | $194.98 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $144.54 | Professional | None | $39.81 | $39.81 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $154.88 Typical High $346.74 | Facility | None | $100.00 | $154.88 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $77.62 Typical High $354.81 | Professional | None | $21.38 | $77.62 | $354.81 |
Emblem Health Setting Facility Modifier None Typical Low $30.90 Median $38.90 Typical High $120.23 | Facility | None | $30.90 | $38.90 | $120.23 |
Emblem Health Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $208.93 | Professional | None | $109.65 | $125.89 | $208.93 |
Excellus BCBS Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $134.90 | Professional | None | $67.61 | $95.50 | $134.90 |
Highmark BCBS Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Facility | None | $831.76 | $831.76 | $831.76 |
MVP Health Care Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
MVP Health Care Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $251.19 | Professional | None | $40.74 | $40.74 | $251.19 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $25.12 Median $77.62 Typical High $208.93 | Professional | None | $25.12 | $77.62 | $208.93 |
Univera Setting Facility Modifier None Typical Low $19.50 Median $91.20 Typical High $134.90 | Facility | None | $19.50 | $91.20 | $134.90 |
Univera Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $131.83 | Professional | None | $67.61 | $91.20 | $131.83 |
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 $18.20 Median $50.12 Typical High $66.07 | Professional | 52 · Reduced service | $18.20 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $19.95 Typical High $26.30 | Professional | 53 · Discontinued | $7.24 | $19.95 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $74.13 Typical High $100.00 | Professional | 54 · Surgery only | $27.54 | $74.13 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $14.79 Typical High $19.95 | Professional | 55 · Aftercare only | $5.50 | $14.79 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $10.00 Typical High $13.18 | Professional | 56 · Pre-op care only | $3.63 | $10.00 | $13.18 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $67.61 Typical High $100.00 | Professional | 53 · Discontinued | $50.12 | $67.61 | $100.00 |
Where New York sits
The same service costs 5.4 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· 33rd of 51
$97.72
WI $209HI $38.90
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.