How much rates vary
Facilitymedian $2,754 · 10th to 90th $363 to $5,129Professionalmedian $135 · 10th to 90th $74 to $195
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 $977.24 Median $3,801.89 Typical High $7,762.47 | Facility | None | $977.24 | $3,801.89 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $154.88 Typical High $208.93 | Professional | None | $104.71 | $154.88 | $208.93 |
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 $125.89 Median $147.91 Typical High $194.98 | Professional | None | $125.89 | $147.91 | $194.98 |
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 $134.90 Median $134.90 Typical High $213.80 | Professional | None | $134.90 | $134.90 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,318.26 Typical High $1,778.28 | Facility | None | $676.08 | $1,318.26 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $218.78 | Professional | None | $74.13 | $120.23 | $218.78 |
Emblem Health Setting Facility Modifier None Typical Low $91.20 Median $109.65 Typical High $354.81 | Facility | None | $91.20 | $109.65 | $354.81 |
Emblem Health Setting Professional Modifier None Typical Low $138.04 Median $199.53 Typical High $338.84 | Professional | None | $138.04 | $199.53 | $338.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $194.98 | Professional | None | $87.10 | $134.90 | $194.98 |
Highmark BCBS Setting Facility Modifier None Typical Low $478.63 Median $691.83 Typical High $1,445.44 | Facility | None | $478.63 | $691.83 | $1,445.44 |
Highmark BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $190.55 | Professional | None | $134.90 | $134.90 | $190.55 |
MVP Health Care Setting Facility Modifier None Typical Low $47.86 Median $1,819.70 Typical High $8,511.38 | Facility | None | $47.86 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $194.98 | Professional | None | $34.67 | $34.67 | $194.98 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,258.93 Typical High $4,365.16 | Facility | None | $363.08 | $1,258.93 | $4,365.16 |
United Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $181.97 | Professional | None | $70.79 | $117.49 | $181.97 |
Univera Setting Facility Modifier None Typical Low $60.26 Median $138.04 Typical High $194.98 | Facility | None | $60.26 | $138.04 | $194.98 |
Univera Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $194.98 | Professional | None | $87.10 | $138.04 | $194.98 |
5 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 $52.48 Median $77.62 Typical High $79.43 | Professional | 52 · Reduced service | $52.48 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $30.90 Typical High $32.36 | Professional | 53 · Discontinued | $20.89 | $30.90 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $114.82 Typical High $120.23 | Professional | 54 · Surgery only | $79.43 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $22.91 Typical High $23.99 | Professional | 55 · Aftercare only | $15.85 | $22.91 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.49 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.47 | $15.49 | $16.22 |
Where New York sits
The same service costs 13.3 times more in Connecticut than in Michigan. 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.
Physician feeFacility fee
CT $3,018MI $226
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.