How much rates vary
Facilitymedian $4,898 · 10th to 90th $447 to $10,965Professionalmedian $295 · 10th to 90th $72 to $550
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 $190.55 Median $3,715.35 Typical High $8,128.31 | Facility | None | $190.55 | $3,715.35 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $389.05 Typical High $467.74 | Professional | None | $95.50 | $389.05 | $467.74 |
Ambetter Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $144.54 | Professional | None | $41.69 | $41.69 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $5,495.41 Typical High $12,302.69 | Facility | None | $3,467.37 | $5,495.41 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $524.81 | Professional | None | $251.19 | $295.12 | $524.81 |
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 $100.00 Median $100.00 Typical High $602.56 | Professional | None | $100.00 | $100.00 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $208.93 Typical High $616.60 | Professional | None | $51.29 | $208.93 | $616.60 |
Emblem Health Setting Facility Modifier None Typical Low $70.79 Median $102.33 Typical High $239.88 | Facility | None | $70.79 | $102.33 | $239.88 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $707.95 | Professional | None | $426.58 | $478.63 | $707.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $588.84 | Professional | None | $269.15 | $354.81 | $588.84 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $4,466.84 Typical High $12,302.69 | Facility | None | $2,818.38 | $4,466.84 | $12,302.69 |
Highmark BCBS Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $371.54 | Professional | None | $64.57 | $87.10 | $371.54 |
MVP Health Care Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
MVP Health Care Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $954.99 | Professional | None | $309.03 | $309.03 | $954.99 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $5,128.61 Typical High $11,481.54 | Facility | None | $2,398.83 | $5,128.61 | $11,481.54 |
United Setting Professional Modifier None Typical Low $52.48 Median $275.42 Typical High $524.81 | Professional | None | $52.48 | $275.42 | $524.81 |
Univera Setting Facility Modifier None Typical Low $44.67 Median $91.20 Typical High $204.17 | Facility | None | $44.67 | $91.20 | $204.17 |
Univera Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $537.03 | Professional | None | $218.78 | $380.19 | $537.03 |
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 $47.86 Median $190.55 Typical High $213.80 | Professional | 52 · Reduced service | $47.86 | $190.55 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $75.86 Typical High $87.10 | Professional | 53 · Discontinued | $19.05 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $288.40 Typical High $323.59 | Professional | 54 · Surgery only | $70.79 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $57.54 Typical High $64.57 | Professional | 55 · Aftercare only | $14.13 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $38.02 Typical High $43.65 | Professional | 56 · Pre-op care only | $9.55 | $38.02 | $43.65 |
Where New York sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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· 40th of 51
$302
WI $617MD $110
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.