How much rates vary
Facilitymedian $2,692 · 10th to 90th $229 to $5,012Professionalmedian $102 · 10th to 90th $35 to $148
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 $165.96 Median $3,548.13 Typical High $7,762.47 | Facility | None | $165.96 | $3,548.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $81.28 Typical High $134.90 | Professional | None | $47.86 | $81.28 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $213.80 | Professional | None | $100.00 | $123.03 | $213.80 |
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 $102.33 Median $120.23 Typical High $158.49 | Professional | None | $102.33 | $120.23 | $158.49 |
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 $56.23 Median $56.23 Typical High $169.82 | Professional | None | $56.23 | $56.23 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $100.00 Typical High $1,949.84 | Facility | None | $69.18 | $100.00 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $97.72 Typical High $158.49 | Professional | None | $32.36 | $97.72 | $158.49 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $50.12 Typical High $158.49 | Facility | None | $34.67 | $50.12 | $158.49 |
Emblem Health Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $263.03 | Professional | None | $112.20 | $154.88 | $263.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $70.79 Median $104.71 Typical High $151.36 | Professional | None | $70.79 | $104.71 | $151.36 |
Highmark BCBS Setting Facility Modifier None Typical Low $0.42 Median $190.55 Typical High $2,041.74 | Facility | None | $0.42 | $190.55 | $2,041.74 |
Highmark BCBS Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $288.40 | Professional | None | $104.71 | $158.49 | $288.40 |
MVP Health Care Setting Facility Modifier None Typical Low $38.02 Median $1,819.70 Typical High $8,511.38 | Facility | None | $38.02 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $190.55 | Professional | None | $34.67 | $34.67 | $190.55 |
United Setting Facility Modifier None Typical Low $338.84 Median $1,148.15 Typical High $4,365.16 | Facility | None | $338.84 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $32.36 Median $77.62 Typical High $125.89 | Professional | None | $32.36 | $77.62 | $125.89 |
Univera Setting Facility Modifier None Typical Low $26.30 Median $85.11 Typical High $147.91 | Facility | None | $26.30 | $85.11 | $147.91 |
Univera Setting Professional Modifier None Typical Low $70.79 Median $112.20 Typical High $147.91 | Professional | None | $70.79 | $112.20 | $147.91 |
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 $23.44 Median $38.02 Typical High $56.23 | Professional | 52 · Reduced service | $23.44 | $38.02 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $15.14 Typical High $22.39 | Professional | 53 · Discontinued | $9.55 | $15.14 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $56.23 Typical High $83.18 | Professional | 54 · Surgery only | $35.48 | $56.23 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $11.22 Typical High $16.60 | Professional | 55 · Aftercare only | $7.08 | $11.22 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.59 Typical High $11.22 | Professional | 56 · Pre-op care only | $4.79 | $7.59 | $11.22 |
Fidelis Setting Professional Modifier 59 · Distinct service Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 59 · Distinct service | $120.23 | $120.23 | $120.23 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $69.18 Typical High $107.15 | Professional | 53 · Discontinued | $52.48 | $69.18 | $107.15 |
Where New York sits
The same service costs 3.4 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· 21st of 51
$105
AK $178DC $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.