How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,122 to $10,715Professionalmedian $316 · 10th to 90th $257 to $708
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 $1,513.56 Median $3,890.45 Typical High $7,762.47 | Facility | None | $1,513.56 | $3,890.45 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $1,071.52 | Professional | None | $407.38 | $426.58 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $630.96 | Professional | None | $263.03 | $309.03 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $467.74 Typical High $933.25 | Professional | 50 · Both sides | $398.11 | $467.74 | $933.25 |
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 $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $4,365.16 Typical High $8,912.51 | Facility | None | $954.99 | $4,365.16 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $446.68 Typical High $1,380.38 | Professional | None | $309.03 | $446.68 | $1,380.38 |
Emblem Health Setting Facility Modifier None Typical Low $251.19 Median $389.05 Typical High $1,202.26 | Facility | None | $251.19 | $389.05 | $1,202.26 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $630.96 | Professional | None | $331.13 | $380.19 | $630.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $562.34 | Professional | None | $245.47 | $302.00 | $562.34 |
MVP Health Care Setting Facility Modifier None Typical Low $398.11 Median $1,819.70 Typical High $8,511.38 | Facility | None | $398.11 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $870.96 | Professional | None | $489.78 | $489.78 | $870.96 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $8,709.64 | Facility | None | $1,122.02 | $2,754.23 | $8,709.64 |
United Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $977.24 | Professional | None | $251.19 | $371.54 | $977.24 |
Univera Setting Facility Modifier None Typical Low $295.12 Median $316.23 Typical High $1,318.26 | Facility | None | $295.12 | $316.23 | $1,318.26 |
Univera Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $512.86 | Professional | None | $245.47 | $302.00 | $512.86 |
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 $204.17 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $204.17 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $81.28 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $302.00 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $60.26 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $42.66 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $239.88 Typical High $354.81 | Professional | 53 · Discontinued | $181.97 | $239.88 | $354.81 |
Where New York sits
The same service costs 7.8 times more in Oklahoma than in New York. 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· 51st of 51
$339
OK $2,630NY $339
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.