How much rates vary
Facilitymedian $3,162 · 10th to 90th $100 to $5,888Professionalmedian $83 · 10th to 90th $45 to $135
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 $91.20 Median $2,238.72 Typical High $7,762.47 | Facility | None | $91.20 | $2,238.72 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $131.83 | Professional | None | $64.57 | $100.00 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $18.62 Median $89.13 Typical High $181.97 | Professional | None | $18.62 | $89.13 | $181.97 |
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 $70.79 Median $83.18 Typical High $125.89 | Professional | None | $70.79 | $83.18 | $125.89 |
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 $125.89 | Professional | None | $61.66 | $61.66 | $125.89 |
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 $75.86 Typical High $158.49 | Professional | None | $37.15 | $75.86 | $158.49 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $47.86 Typical High $144.54 | Facility | None | $34.67 | $47.86 | $144.54 |
Emblem Health Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | None | $123.03 | $123.03 | $144.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $141.25 | Professional | None | $61.66 | $87.10 | $141.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $50.12 Median $891.25 Typical High $2,137.96 | Facility | None | $50.12 | $891.25 | $2,137.96 |
MVP Health Care Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
MVP Health Care Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $194.98 | Professional | None | $95.50 | $95.50 | $194.98 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $2,818.38 Typical High $4,897.79 | Facility | None | $1,318.26 | $2,818.38 | $4,897.79 |
United Setting Professional Modifier None Typical Low $33.88 Median $67.61 Typical High $112.20 | Professional | None | $33.88 | $67.61 | $112.20 |
Univera Setting Facility Modifier None Typical Low $36.31 Median $51.29 Typical High $380.19 | Facility | None | $36.31 | $51.29 | $380.19 |
Univera Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $141.25 | Professional | None | $61.66 | $87.10 | $141.25 |
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 $41.69 Median $48.98 Typical High $66.07 | Professional | 52 · Reduced service | $41.69 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $19.50 Typical High $26.30 | Professional | 53 · Discontinued | $16.60 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $72.44 Typical High $100.00 | Professional | 54 · Surgery only | $63.10 | $72.44 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.45 Typical High $19.95 | Professional | 55 · Aftercare only | $12.59 | $14.45 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.77 Typical High $13.18 | Professional | 56 · Pre-op care only | $8.32 | $9.77 | $13.18 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $54.95 Typical High $87.10 | Professional | 53 · Discontinued | $43.65 | $54.95 | $87.10 |
Where New York sits
The same service costs 2.5 times more in North Carolina than in Florida. 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· 46th of 51
$83.18
NC $174FL $70.79
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.