How much rates vary
Facilitymedian $2,818 · 10th to 90th $562 to $5,495Professionalmedian $891 · 10th to 90th $115 to $1,549
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 $1,230.27 Median $4,570.88 Typical High $8,128.31 | Facility | None | $1,230.27 | $4,570.88 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $870.96 Typical High $1,348.96 | Professional | None | $141.25 | $870.96 | $1,348.96 |
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 $758.58 Median $891.25 Typical High $1,659.59 | Professional | None | $758.58 | $891.25 | $1,659.59 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $1,819.70 | Professional | None | $165.96 | $165.96 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,698.24 Typical High $2,818.38 | Facility | None | $912.01 | $1,698.24 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $741.31 Typical High $1,513.56 | Professional | None | $89.13 | $741.31 | $1,513.56 |
Emblem Health Setting Facility Modifier None Typical Low $112.20 Median $147.91 Typical High $436.52 | Facility | None | $112.20 | $147.91 | $436.52 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,445.44 | $2,454.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,584.89 | Professional | None | $794.33 | $1,148.15 | $1,584.89 |
MVP Health Care Setting Facility Modifier None Typical Low $147.91 Median $3,235.94 Typical High $4,365.16 | Facility | None | $147.91 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,621.81 | Professional | None | $954.99 | $954.99 | $1,621.81 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $4,897.79 | Facility | None | $549.54 | $1,862.09 | $4,897.79 |
United Setting Professional Modifier None Typical Low $89.13 Median $724.44 Typical High $1,348.96 | Professional | None | $89.13 | $724.44 | $1,348.96 |
Univera Setting Facility Modifier None Typical Low $75.86 Median $208.93 Typical High $1,548.82 | Facility | None | $75.86 | $208.93 | $1,548.82 |
Univera Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $1,584.89 | Professional | None | $794.33 | $1,148.15 | $1,584.89 |
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 $70.79 Median $416.87 Typical High $575.44 | Professional | 52 · Reduced service | $70.79 | $416.87 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $165.96 Typical High $229.09 | Professional | 53 · Discontinued | $28.18 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $616.60 Typical High $851.14 | Professional | 54 · Surgery only | $104.71 | $616.60 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $125.89 Typical High $169.82 | Professional | 55 · Aftercare only | $20.89 | $125.89 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $83.18 Typical High $114.82 | Professional | 56 · Pre-op care only | $14.13 | $83.18 | $114.82 |
Where New York sits
The same service costs 5.5 times more in Hawaii 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.
Physician feeFacility fee
HI $4,440MD $808
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.