How much rates vary
Facilitymedian $3,236 · 10th to 90th $145 to $5,888Professionalmedian $148 · 10th to 90th $46 to $309
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 $53.70 Median $2,951.21 Typical High $8,317.64 | Facility | None | $53.70 | $2,951.21 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $162.18 Typical High $251.19 | Professional | None | $50.12 | $162.18 | $251.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,548.13 Typical High $4,897.79 | Facility | None | $1,819.70 | $3,548.13 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $302.00 | Professional | None | $125.89 | $147.91 | $302.00 |
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 $61.66 Median $61.66 Typical High $309.03 | Professional | None | $61.66 | $61.66 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $107.15 Typical High $346.74 | Professional | None | $37.15 | $107.15 | $346.74 |
Emblem Health Setting Facility Modifier None Typical Low $42.66 Median $77.62 Typical High $151.36 | Facility | None | $42.66 | $77.62 | $151.36 |
Emblem Health Setting Professional Modifier None Typical Low $223.87 Median $251.19 Typical High $363.08 | Professional | None | $223.87 | $251.19 | $363.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $323.59 | Professional | None | $141.25 | $199.53 | $323.59 |
Highmark BCBS Setting Facility Modifier None Typical Low $102.33 Median $186.21 Typical High $3,630.78 | Facility | None | $102.33 | $186.21 | $3,630.78 |
Highmark BCBS Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $251.19 | Professional | None | $83.18 | $93.33 | $251.19 |
MVP Health Care Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
MVP Health Care Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $512.86 | Professional | None | $50.12 | $50.12 | $512.86 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $2,951.21 Typical High $5,011.87 | Facility | None | $1,318.26 | $2,951.21 | $5,011.87 |
United Setting Professional Modifier None Typical Low $32.36 Median $147.91 Typical High $281.84 | Professional | None | $32.36 | $147.91 | $281.84 |
Univera Setting Facility Modifier None Typical Low $35.48 Median $50.12 Typical High $151.36 | Facility | None | $35.48 | $50.12 | $151.36 |
Univera Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $316.23 | Professional | None | $141.25 | $199.53 | $316.23 |
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 $25.12 Median $81.28 Typical High $112.20 | Professional | 52 · Reduced service | $25.12 | $81.28 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $32.36 Typical High $44.67 | Professional | 53 · Discontinued | $10.00 | $32.36 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $24.55 Typical High $33.88 | Professional | 55 · Aftercare only | $7.59 | $24.55 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $16.22 Typical High $22.39 | Professional | 56 · Pre-op care only | $5.01 | $16.22 | $22.39 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $186.21 Median $218.78 Typical High $218.78 | Professional | GL · Free upgrade | $186.21 | $218.78 | $218.78 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $134.90 Typical High $199.53 | Professional | 53 · Discontinued | $107.15 | $134.90 | $199.53 |
Where New York sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 43rd of 51
$148
NC $309HI $58.88
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.