How much rates vary
Facilitymedian $2,754 · 10th to 90th $407 to $5,623Professionalmedian $105 · 10th to 90th $83 to $158
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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,621.81 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $120.23 | Professional | None | $109.65 | $120.23 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $758.58 Median $3,019.95 Typical High $4,786.30 | Facility | None | $758.58 | $3,019.95 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $162.18 | Professional | None | $87.10 | $104.71 | $162.18 |
CDPHP Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $2,754.23 | Facility | None | $794.33 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $208.93 | Professional | None | $91.20 | $91.20 | $208.93 |
Emblem Health Setting Facility Modifier None Typical Low $102.33 Median $117.49 Typical High $398.11 | Facility | None | $102.33 | $117.49 | $398.11 |
Emblem Health Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $199.53 | Professional | None | $100.00 | $112.20 | $199.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $141.25 | Professional | None | $70.79 | $89.13 | $141.25 |
MVP Health Care Setting Facility Modifier None Typical Low $107.15 Median $3,235.94 Typical High $4,365.16 | Facility | None | $107.15 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $204.17 | Professional | None | $138.04 | $138.04 | $204.17 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $162.18 | Professional | None | $72.44 | $102.33 | $162.18 |
Univera Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $446.68 | Facility | None | $66.07 | $100.00 | $446.68 |
Univera Setting Professional Modifier None Typical Low $70.79 Median $89.13 Typical High $141.25 | Professional | None | $70.79 | $89.13 | $141.25 |
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 $54.95 Median $60.26 Typical High $60.26 | Professional | 52 · Reduced service | $54.95 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.99 Typical High $23.99 | Professional | 53 · Discontinued | $22.39 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $91.20 Typical High $91.20 | Professional | 54 · Surgery only | $83.18 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $16.60 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $12.02 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.96 | $12.02 | $12.02 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $74.13 Typical High $102.33 | Professional | 53 · Discontinued | $56.23 | $74.13 | $102.33 |
Where New York sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 48th of 51
$105
AK $427NJ $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.