How much rates vary
Facilitymedian $2,692 · 10th to 90th $145 to $5,012Professionalmedian $47 · 10th to 90th $30 to $98
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 $51.29 Median $3,548.13 Typical High $7,762.47 | Facility | None | $51.29 | $3,548.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $51.29 Typical High $81.28 | Professional | None | $29.51 | $51.29 | $81.28 |
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 $39.81 Median $47.86 Typical High $87.10 | Professional | None | $39.81 | $47.86 | $87.10 |
CDPHP Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $64.57 | Professional | None | $35.48 | $35.48 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $100.00 Typical High $1,096.48 | Facility | None | $39.81 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $23.44 Median $45.71 Typical High $162.18 | Professional | None | $23.44 | $45.71 | $162.18 |
Emblem Health Setting Facility Modifier None Typical Low $23.99 Median $30.90 Typical High $91.20 | Facility | None | $23.99 | $30.90 | $91.20 |
Emblem Health Setting Professional Modifier None Typical Low $53.70 Median $58.88 Typical High $93.33 | Professional | None | $53.70 | $58.88 | $93.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $30.90 Median $43.65 Typical High $70.79 | Professional | None | $30.90 | $43.65 | $70.79 |
Highmark BCBS Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $2,398.83 | Facility | None | $190.55 | $190.55 | $2,398.83 |
MVP Health Care Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $112.20 | Professional | None | $39.81 | $39.81 | $112.20 |
United Setting Facility Modifier None Typical Low $338.84 Median $1,148.15 Typical High $4,365.16 | Facility | None | $338.84 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $20.89 Median $41.69 Typical High $112.20 | Professional | None | $20.89 | $41.69 | $112.20 |
Univera Setting Facility Modifier None Typical Low $20.89 Median $29.51 Typical High $186.21 | Facility | None | $20.89 | $29.51 | $186.21 |
Univera Setting Professional Modifier None Typical Low $29.51 Median $42.66 Typical High $69.18 | Professional | None | $29.51 | $42.66 | $69.18 |
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 $14.79 Median $25.12 Typical High $33.11 | Professional | 52 · Reduced service | $14.79 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $10.23 Typical High $13.18 | Professional | 53 · Discontinued | $5.89 | $10.23 | $13.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $38.02 Typical High $50.12 | Professional | 54 · Surgery only | $22.39 | $38.02 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $7.59 Typical High $10.00 | Professional | 55 · Aftercare only | $4.47 | $7.59 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $5.13 Typical High $6.61 | Professional | 56 · Pre-op care only | $2.95 | $5.13 | $6.61 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.20 Typical High $46.77 | Professional | 53 · Discontinued | $22.39 | $30.20 | $46.77 |
Where New York sits
The same service costs 3.4 times more in Wisconsin than in Utah. 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
$47.86
WI $132UT $38.90
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.