How much rates vary
Facilitymedian $3,388 · 10th to 90th $724 to $6,310Professionalmedian $120 · 10th to 90th $63 to $224
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 $1,318.26 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $141.25 Typical High $169.82 | Professional | None | $70.79 | $141.25 | $169.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,548.13 Typical High $4,897.79 | Facility | None | $1,819.70 | $3,548.13 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $204.17 | Professional | None | $104.71 | $123.03 | $204.17 |
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 $87.10 Median $87.10 Typical High $229.09 | Professional | None | $87.10 | $87.10 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $120.23 Typical High $263.03 | Professional | None | $44.67 | $120.23 | $263.03 |
Emblem Health Setting Facility Modifier None Typical Low $58.88 Median $70.79 Typical High $199.53 | Facility | None | $58.88 | $70.79 | $199.53 |
Emblem Health Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $257.04 | Professional | None | $158.49 | $173.78 | $257.04 |
Excellus BCBS Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $199.53 | Professional | None | $100.00 | $138.04 | $199.53 |
MVP Health Care Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
MVP Health Care Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $389.05 | Professional | None | $63.10 | $63.10 | $389.05 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $2,951.21 Typical High $5,011.87 | Facility | None | $1,318.26 | $2,951.21 | $5,011.87 |
United Setting Professional Modifier None Typical Low $46.77 Median $117.49 Typical High $251.19 | Professional | None | $46.77 | $117.49 | $251.19 |
Univera Setting Facility Modifier None Typical Low $39.81 Median $79.43 Typical High $288.40 | Facility | None | $39.81 | $79.43 | $288.40 |
Univera Setting Professional Modifier None Typical Low $100.00 Median $141.25 Typical High $199.53 | Professional | None | $100.00 | $141.25 | $199.53 |
7 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 $35.48 Median $70.79 Typical High $85.11 | Professional | 52 · Reduced service | $35.48 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $28.84 Typical High $33.88 | Professional | 53 · Discontinued | $14.13 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $107.15 Typical High $125.89 | Professional | 54 · Surgery only | $53.70 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $21.38 Typical High $25.12 | Professional | 55 · Aftercare only | $10.72 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $14.13 Typical High $16.98 | Professional | 56 · Pre-op care only | $7.08 | $14.13 | $16.98 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $141.25 Median $162.18 Typical High $165.96 | Professional | GL · Free upgrade | $141.25 | $162.18 | $165.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $100.00 Typical High $151.36 | Professional | 53 · Discontinued | $79.43 | $100.00 | $151.36 |
Where New York sits
The same service costs 3.7 times more in Wisconsin than in Maryland. 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· 42nd of 51
$123
WI $302MD $81.28
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.