How much rates vary
Facilitymedian $2,754 · 10th to 90th $525 to $5,370Professionalmedian $347 · 10th to 90th $204 to $724
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 $4,073.80 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,073.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $446.68 Typical High $457.09 | Professional | None | $186.21 | $446.68 | $457.09 |
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 $295.12 Median $346.74 Typical High $691.83 | Professional | None | $295.12 | $346.74 | $691.83 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $575.44 | Professional | None | $229.09 | $229.09 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $707.95 Typical High $1,737.80 | Facility | None | $416.87 | $707.95 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $338.84 Typical High $1,047.13 | Professional | None | $141.25 | $338.84 | $1,047.13 |
Emblem Health Setting Facility Modifier None Typical Low $169.82 Median $275.42 Typical High $602.56 | Facility | None | $169.82 | $275.42 | $602.56 |
Emblem Health Setting Professional Modifier None Typical Low $61.66 Median $213.80 Typical High $257.04 | Professional | None | $61.66 | $213.80 | $257.04 |
Excellus BCBS Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $562.34 | Professional | None | $251.19 | $346.74 | $562.34 |
MVP Health Care Setting Facility Modifier None Typical Low $181.97 Median $1,819.70 Typical High $8,511.38 | Facility | None | $181.97 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $933.25 | Professional | None | $288.40 | $288.40 | $933.25 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $4,897.79 | Facility | None | $549.54 | $1,737.80 | $4,897.79 |
United Setting Professional Modifier None Typical Low $134.90 Median $323.59 Typical High $891.25 | Professional | None | $134.90 | $323.59 | $891.25 |
Univera Setting Facility Modifier None Typical Low $138.04 Median $354.81 Typical High $588.84 | Facility | None | $138.04 | $354.81 | $588.84 |
Univera Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $524.81 | Professional | None | $251.19 | $346.74 | $524.81 |
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 $93.33 Median $199.53 Typical High $229.09 | Professional | 52 · Reduced service | $93.33 | $199.53 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $79.43 Typical High $91.20 | Professional | 53 · Discontinued | $37.15 | $79.43 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $302.00 Typical High $338.84 | Professional | 54 · Surgery only | $141.25 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $60.26 Typical High $67.61 | Professional | 55 · Aftercare only | $28.18 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $39.81 Typical High $45.71 | Professional | 56 · Pre-op care only | $18.62 | $39.81 | $45.71 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $263.03 Typical High $389.05 | Professional | 53 · Discontinued | $199.53 | $263.03 | $389.05 |
Where New York sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 48th of 51
$347
WI $871KY $309
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.