How much rates vary
Facilitymedian $3,162 · 10th to 90th $575 to $7,244Professionalmedian $288 · 10th to 90th $186 to $603
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 $275.42 Median $3,311.31 Typical High $7,762.47 | Facility | None | $275.42 | $3,311.31 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $331.13 Typical High $512.86 | Professional | None | $173.78 | $331.13 | $512.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $588.84 | Professional | None | $245.47 | $288.40 | $588.84 |
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 $213.80 Median $213.80 Typical High $478.63 | Professional | None | $213.80 | $213.80 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $3,467.37 | Facility | None | $1,096.48 | $1,737.80 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $295.12 Typical High $954.99 | Professional | None | $131.83 | $295.12 | $954.99 |
Emblem Health Setting Facility Modifier None Typical Low $158.49 Median $257.04 Typical High $562.34 | Facility | None | $158.49 | $257.04 | $562.34 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $676.08 | Professional | None | $338.84 | $380.19 | $676.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $478.63 | Professional | None | $213.80 | $295.12 | $478.63 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $2,630.27 Typical High $5,011.87 | Facility | None | $1,258.93 | $2,630.27 | $5,011.87 |
MVP Health Care Setting Facility Modifier None Typical Low $169.82 Median $1,819.70 Typical High $8,511.38 | Facility | None | $169.82 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $794.33 | Professional | None | $309.03 | $309.03 | $794.33 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,238.72 Typical High $6,309.57 | Facility | None | $831.76 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $123.03 Median $281.84 Typical High $724.44 | Professional | None | $123.03 | $281.84 | $724.44 |
Univera Setting Facility Modifier None Typical Low $125.89 Median $302.00 Typical High $562.34 | Facility | None | $125.89 | $302.00 | $562.34 |
Univera Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $446.68 | Professional | None | $213.80 | $295.12 | $446.68 |
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 $87.10 Median $147.91 Typical High $190.55 | Professional | 52 · Reduced service | $87.10 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $58.88 Typical High $77.62 | Professional | 53 · Discontinued | $34.67 | $58.88 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $218.78 Typical High $288.40 | Professional | 54 · Surgery only | $128.82 | $218.78 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $44.67 Typical High $57.54 | Professional | 55 · Aftercare only | $25.70 | $44.67 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $29.51 Typical High $38.90 | Professional | 56 · Pre-op care only | $17.38 | $29.51 | $38.90 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $213.80 Typical High $331.13 | Professional | 53 · Discontinued | $162.18 | $213.80 | $331.13 |
Where New York sits
The same service costs 3.0 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· 48th of 51
$302
WI $851UT $288
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.