How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,202 to $11,749Professionalmedian $398 · 10th to 90th $316 to $575
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 $1,819.70 Median $5,248.07 Typical High $11,220.18 | Facility | None | $1,819.70 | $5,248.07 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $478.63 | Professional | None | $426.58 | $478.63 | $478.63 |
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 $338.84 Median $398.11 Typical High $562.34 | Professional | None | $338.84 | $398.11 | $562.34 |
CDPHP Setting Facility Modifier None Typical Low $4,265.80 Median $5,495.41 Typical High $16,595.87 | Facility | None | $4,265.80 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $7,413.10 Typical High $15,135.61 | Facility | None | $2,238.72 | $7,413.10 | $15,135.61 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $323.59 Typical High $812.83 | Professional | None | $309.03 | $323.59 | $812.83 |
Emblem Health Setting Facility Modifier None Typical Low $416.87 Median $691.83 Typical High $1,479.11 | Facility | None | $416.87 | $691.83 | $1,479.11 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $724.44 | Professional | None | $363.08 | $426.58 | $724.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $537.03 | Professional | None | $269.15 | $346.74 | $537.03 |
MVP Health Care Setting Facility Modifier None Typical Low $457.09 Median $1,819.70 Typical High $8,511.38 | Facility | None | $457.09 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $602.56 | Professional | None | $457.09 | $457.09 | $602.56 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,232.93 | Facility | None | $1,230.27 | $3,162.28 | $10,232.93 |
United Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $588.84 | Professional | None | $263.03 | $371.54 | $588.84 |
Univera Setting Facility Modifier None Typical Low $257.04 Median $363.08 Typical High $1,584.89 | Facility | None | $257.04 | $363.08 | $1,584.89 |
Univera Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $524.81 | Professional | None | $269.15 | $363.08 | $524.81 |
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 $213.80 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $213.80 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $85.11 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $363.08 Typical High $363.08 | Professional | 54 · Surgery only | $316.23 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $63.10 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $42.66 | $47.86 | $47.86 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $275.42 Typical High $407.38 | Professional | 53 · Discontinued | $213.80 | $275.42 | $407.38 |
Where New York sits
The same service costs 4.5 times more in Alaska than in Texas. 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· 47th of 51
$398
AK $1,622TX $363
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.