How much rates vary
Facilitymedian $2,818 · 10th to 90th $631 to $5,623Professionalmedian $170 · 10th to 90th $79 to $282
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 $95.50 Median $154.88 Typical High $245.47 | Professional | None | $95.50 | $154.88 | $245.47 |
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 $144.54 Median $169.82 Typical High $295.12 | Professional | None | $144.54 | $169.82 | $295.12 |
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 $112.20 Median $112.20 Typical High $323.59 | Professional | None | $112.20 | $112.20 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,122.02 Typical High $1,737.80 | Facility | None | $616.60 | $1,122.02 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $181.97 Typical High $309.03 | Professional | None | $63.10 | $181.97 | $309.03 |
Emblem Health Setting Facility Modifier None Typical Low $85.11 Median $100.00 Typical High $309.03 | Facility | None | $85.11 | $100.00 | $309.03 |
Emblem Health Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $489.78 | Professional | None | $213.80 | $288.40 | $489.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $288.40 | Professional | None | $144.54 | $204.17 | $288.40 |
MVP Health Care Setting Facility Modifier None Typical Low $85.11 Median $1,819.70 Typical High $8,511.38 | Facility | None | $85.11 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $380.19 | Professional | None | $144.54 | $144.54 | $380.19 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,137.96 Typical High $6,309.57 | Facility | None | $831.76 | $2,137.96 | $6,309.57 |
United Setting Professional Modifier None Typical Low $61.66 Median $154.88 Typical High $245.47 | Professional | None | $61.66 | $154.88 | $245.47 |
Univera Setting Facility Modifier None Typical Low $51.29 Median $213.80 Typical High $389.05 | Facility | None | $51.29 | $213.80 | $389.05 |
Univera Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $288.40 | Professional | None | $144.54 | $213.80 | $288.40 |
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 $46.77 Median $77.62 Typical High $107.15 | Professional | 52 · Reduced service | $46.77 | $77.62 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $30.90 Typical High $42.66 | Professional | 53 · Discontinued | $19.05 | $30.90 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $114.82 Typical High $162.18 | Professional | 54 · Surgery only | $70.79 | $114.82 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $23.44 Typical High $32.36 | Professional | 55 · Aftercare only | $14.13 | $23.44 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $15.49 Typical High $21.38 | Professional | 56 · Pre-op care only | $9.33 | $15.49 | $21.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $134.90 Typical High $204.17 | Professional | 53 · Discontinued | $104.71 | $134.90 | $204.17 |
Where New York sits
The same service costs 4.1 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· 38th of 51
$170
AK $398DC $97.72
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.