How much rates vary
Facilitymedian $3,162 · 10th to 90th $759 to $7,413Professionalmedian $166 · 10th to 90th $91 to $269
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 $1,348.96 Median $3,801.89 Typical High $7,762.47 | Facility | None | $1,348.96 | $3,801.89 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $263.03 | Professional | None | $112.20 | $186.21 | $263.03 |
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 $134.90 Median $158.49 Typical High $281.84 | Professional | None | $134.90 | $158.49 | $281.84 |
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 $125.89 Median $125.89 Typical High $302.00 | Professional | None | $125.89 | $125.89 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $1,258.93 Typical High $2,238.72 | Facility | None | $776.25 | $1,258.93 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $173.78 Typical High $309.03 | Professional | None | $74.13 | $173.78 | $309.03 |
Emblem Health Setting Facility Modifier None Typical Low $104.71 Median $173.78 Typical High $363.08 | Facility | None | $104.71 | $173.78 | $363.08 |
Emblem Health Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $489.78 | Professional | None | $199.53 | $281.84 | $489.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $269.15 | Professional | None | $138.04 | $190.55 | $269.15 |
MVP Health Care Setting Facility Modifier None Typical Low $97.72 Median $1,819.70 Typical High $8,511.38 | Facility | None | $97.72 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $398.11 | Professional | None | $165.96 | $165.96 | $398.11 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,187.76 Typical High $6,309.57 | Facility | None | $851.14 | $2,187.76 | $6,309.57 |
United Setting Professional Modifier None Typical Low $74.13 Median $151.36 Typical High $239.88 | Professional | None | $74.13 | $151.36 | $239.88 |
Univera Setting Facility Modifier None Typical Low $67.61 Median $199.53 Typical High $512.86 | Facility | None | $67.61 | $199.53 | $512.86 |
Univera Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $269.15 | Professional | None | $138.04 | $199.53 | $269.15 |
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 $56.23 Median $93.33 Typical High $131.83 | Professional | 52 · Reduced service | $56.23 | $93.33 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $38.02 Typical High $52.48 | Professional | 53 · Discontinued | $22.39 | $38.02 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $141.25 Typical High $194.98 | Professional | 54 · Surgery only | $85.11 | $141.25 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $28.18 Typical High $38.90 | Professional | 55 · Aftercare only | $16.98 | $28.18 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $18.62 Typical High $26.30 | Professional | 56 · Pre-op care only | $11.22 | $18.62 | $26.30 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $128.82 Typical High $199.53 | Professional | 53 · Discontinued | $97.72 | $128.82 | $199.53 |
Where New York sits
The same service costs 4.2 times more in Alaska than in Washington, DC. 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· 43rd of 51
$166
AK $468DC $112
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.