How much rates vary
Facilitymedian $3,162 · 10th to 90th $813 to $7,413Professionalmedian $132 · 10th to 90th $105 to $204
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 $1,548.82 Median $3,890.45 Typical High $8,128.31 | Facility | None | $1,548.82 | $3,890.45 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $173.78 | Professional | None | $141.25 | $162.18 | $173.78 |
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 $109.65 Median $128.82 Typical High $190.55 | Professional | None | $109.65 | $128.82 | $190.55 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,548.82 Typical High $3,162.28 | Facility | None | $954.99 | $1,548.82 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $107.15 Typical High $309.03 | Professional | None | $102.33 | $107.15 | $309.03 |
Emblem Health Setting Facility Modifier None Typical Low $138.04 Median $234.42 Typical High $501.19 | Facility | None | $138.04 | $234.42 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $239.88 | Professional | None | $128.82 | $141.25 | $239.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $181.97 | Professional | None | $91.20 | $128.82 | $181.97 |
MVP Health Care Setting Facility Modifier None Typical Low $229.09 Median $1,819.70 Typical High $8,511.38 | Facility | None | $229.09 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $6,309.57 | Facility | None | $831.76 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $208.93 | Professional | None | $89.13 | $123.03 | $208.93 |
Univera Setting Facility Modifier None Typical Low $85.11 Median $128.82 Typical High $1,148.15 | Facility | None | $85.11 | $128.82 | $1,148.15 |
Univera Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $181.97 | Professional | None | $91.20 | $128.82 | $181.97 |
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 $70.79 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $70.79 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $28.18 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $123.03 Typical High $123.03 | Professional | 54 · Surgery only | $104.71 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $14.13 | $16.22 | $16.22 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $91.20 Typical High $134.90 | Professional | 53 · Discontinued | $70.79 | $91.20 | $134.90 |
Where New York sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 48th of 51
$132
AK $537UT $100
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.