How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,413 to $11,220Professionalmedian $724 · 10th to 90th $214 to $1,175
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 $1,621.81 Median $4,897.79 Typical High $9,120.11 | Facility | None | $1,621.81 | $4,897.79 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $831.76 Typical High $933.25 | Professional | None | $245.47 | $831.76 | $933.25 |
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 $630.96 Median $741.31 Typical High $1,122.02 | Professional | None | $630.96 | $741.31 | $1,122.02 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,148.15 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $1,258.93 | Professional | None | $302.00 | $302.00 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $512.86 Typical High $1,380.38 | Professional | None | $158.49 | $512.86 | $1,380.38 |
Emblem Health Setting Facility Modifier None Typical Low $194.98 Median $245.47 Typical High $707.95 | Facility | None | $194.98 | $245.47 | $707.95 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,412.54 | Professional | None | $870.96 | $977.24 | $1,412.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $537.03 Median $776.25 Typical High $1,071.52 | Professional | None | $537.03 | $776.25 | $1,071.52 |
MVP Health Care Setting Facility Modifier None Typical Low $257.04 Median $3,235.94 Typical High $4,365.16 | Facility | None | $257.04 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $2,137.96 | Professional | None | $724.44 | $724.44 | $2,137.96 |
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 $158.49 Median $575.44 Typical High $1,202.26 | Professional | None | $158.49 | $575.44 | $1,202.26 |
Univera Setting Facility Modifier None Typical Low $131.83 Median $269.15 Typical High $457.09 | Facility | None | $131.83 | $269.15 | $457.09 |
Univera Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $1,047.13 | Professional | None | $512.86 | $776.25 | $1,047.13 |
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 $123.03 Median $398.11 Typical High $467.74 | Professional | 52 · Reduced service | $123.03 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $162.18 Typical High $186.21 | Professional | 53 · Discontinued | $48.98 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $602.56 Typical High $707.95 | Professional | 54 · Surgery only | $186.21 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $120.23 Typical High $141.25 | Professional | 55 · Aftercare only | $37.15 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $79.43 Typical High $93.33 | Professional | 56 · Pre-op care only | $24.55 | $79.43 | $93.33 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $549.54 Typical High $812.83 | Professional | 53 · Discontinued | $436.52 | $549.54 | $812.83 |
Where New York sits
The same service costs 5.4 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· 35th of 51
$724
WI $1,514MD $282
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.