How much rates vary
Facilitymedian $2,754 · 10th to 90th $380 to $5,129Professionalmedian $123 · 10th to 90th $85 to $200
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 $1,318.26 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $162.18 | Professional | None | $107.15 | $151.36 | $162.18 |
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 $104.71 Median $123.03 Typical High $199.53 | Professional | None | $104.71 | $123.03 | $199.53 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $213.80 | Professional | None | $128.82 | $128.82 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $1,778.28 Typical High $1,949.84 | Facility | None | $141.25 | $1,778.28 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $117.49 Typical High $234.42 | Professional | None | $69.18 | $117.49 | $234.42 |
Emblem Health Setting Facility Modifier None Typical Low $50.12 Median $91.20 Typical High $302.00 | Facility | None | $50.12 | $91.20 | $302.00 |
Emblem Health Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $302.00 | Professional | None | $138.04 | $177.83 | $302.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $199.53 | Professional | None | $100.00 | $144.54 | $199.53 |
MVP Health Care Setting Facility Modifier None Typical Low $102.33 Median $3,235.94 Typical High $4,365.16 | Facility | None | $102.33 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $229.09 | Professional | None | $144.54 | $144.54 | $229.09 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $69.18 Median $109.65 Typical High $186.21 | Professional | None | $69.18 | $109.65 | $186.21 |
Univera Setting Facility Modifier None Typical Low $57.54 Median $138.04 Typical High $346.74 | Facility | None | $57.54 | $138.04 | $346.74 |
Univera Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $199.53 | Professional | None | $100.00 | $144.54 | $199.53 |
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 $53.70 Median $72.44 Typical High $79.43 | Professional | 52 · Reduced service | $53.70 | $72.44 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $28.84 Typical High $32.36 | Professional | 53 · Discontinued | $21.38 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $107.15 Typical High $120.23 | Professional | 54 · Surgery only | $79.43 | $107.15 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $21.88 Typical High $23.99 | Professional | 55 · Aftercare only | $16.22 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $14.45 Typical High $16.22 | Professional | 56 · Pre-op care only | $10.72 | $14.45 | $16.22 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $97.72 Typical High $134.90 | Professional | 53 · Discontinued | $75.86 | $97.72 | $134.90 |
Where New York sits
The same service costs 11.3 times more in Hawaii than in Delaware. 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 $2,996DE $264
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.