How much rates vary
Facilitymedian $2,818 · 10th to 90th $479 to $5,248Professionalmedian $135 · 10th to 90th $39 to $209
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 $1,096.48 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,096.48 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $117.49 Typical High $181.97 | Professional | None | $45.71 | $117.49 | $181.97 |
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 $123.03 Median $144.54 Typical High $229.09 | Professional | None | $123.03 | $144.54 | $229.09 |
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 $54.95 Median $54.95 Typical High $239.88 | Professional | None | $54.95 | $54.95 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $1,096.48 | Facility | None | $66.07 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $128.82 Typical High $234.42 | Professional | None | $31.62 | $128.82 | $234.42 |
Emblem Health Setting Facility Modifier None Typical Low $44.67 Median $60.26 Typical High $154.88 | Facility | None | $44.67 | $60.26 | $154.88 |
Emblem Health Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $346.74 | Professional | None | $151.36 | $173.78 | $346.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $208.93 | Professional | None | $97.72 | $151.36 | $208.93 |
MVP Health Care Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
MVP Health Care Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $234.42 | Professional | None | $63.10 | $63.10 | $234.42 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $4,897.79 | Facility | None | $549.54 | $1,862.09 | $4,897.79 |
United Setting Professional Modifier None Typical Low $30.90 Median $95.50 Typical High $181.97 | Professional | None | $30.90 | $95.50 | $181.97 |
Univera Setting Facility Modifier None Typical Low $26.30 Median $134.90 Typical High $204.17 | Facility | None | $26.30 | $134.90 | $204.17 |
Univera Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $208.93 | Professional | None | $97.72 | $151.36 | $208.93 |
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 $22.91 Median $58.88 Typical High $89.13 | Professional | 52 · Reduced service | $22.91 | $58.88 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $23.44 Typical High $36.31 | Professional | 53 · Discontinued | $9.33 | $23.44 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $89.13 Typical High $134.90 | Professional | 54 · Surgery only | $34.67 | $89.13 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $17.78 Typical High $26.92 | Professional | 55 · Aftercare only | $6.92 | $17.78 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $11.75 Typical High $18.20 | Professional | 56 · Pre-op care only | $4.57 | $11.75 | $18.20 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $102.33 Typical High $147.91 | Professional | 53 · Discontinued | $79.43 | $102.33 | $147.91 |
Where New York sits
The same service costs 4.6 times more in Wisconsin 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· 23rd of 51
$138
WI $240DC $52.48
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.