How much rates vary
Facilitymedian $2,884 · 10th to 90th $603 to $5,888Professionalmedian $309 · 10th to 90th $224 to $661
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 $1,174.90 Median $3,981.07 Typical High $8,128.31 | Facility | None | $1,174.90 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $537.03 | Professional | None | $223.87 | $338.84 | $537.03 |
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 $263.03 Median $309.03 Typical High $616.60 | Professional | None | $263.03 | $309.03 | $616.60 |
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 $275.42 Median $275.42 Typical High $489.78 | Professional | None | $275.42 | $275.42 | $489.78 |
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 $165.96 Median $309.03 Typical High $1,122.02 | Professional | None | $165.96 | $309.03 | $1,122.02 |
Emblem Health Setting Facility Modifier None Typical Low $204.17 Median $281.84 Typical High $707.95 | Facility | None | $204.17 | $281.84 | $707.95 |
Emblem Health Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $660.69 | Professional | None | $354.81 | $407.38 | $660.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $478.63 | Professional | None | $234.42 | $309.03 | $478.63 |
MVP Health Care Setting Facility Modifier None Typical Low $213.80 Median $1,819.70 Typical High $8,511.38 | Facility | None | $213.80 | $1,819.70 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $812.83 | Professional | None | $371.54 | $371.54 | $812.83 |
United Setting Facility Modifier None Typical Low $831.76 Median $1,995.26 Typical High $6,309.57 | Facility | None | $831.76 | $1,995.26 | $6,309.57 |
United Setting Professional Modifier None Typical Low $158.49 Median $295.12 Typical High $794.33 | Professional | None | $158.49 | $295.12 | $794.33 |
Univera Setting Facility Modifier None Typical Low $162.18 Median $323.59 Typical High $707.95 | Facility | None | $162.18 | $323.59 | $707.95 |
Univera Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $457.09 | Professional | None | $234.42 | $309.03 | $457.09 |
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 $112.20 Median $169.82 Typical High $204.17 | Professional | 52 · Reduced service | $112.20 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $67.61 Typical High $81.28 | Professional | 53 · Discontinued | $44.67 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $257.04 Typical High $309.03 | Professional | 54 · Surgery only | $165.96 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $51.29 Typical High $61.66 | Professional | 55 · Aftercare only | $33.11 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $33.88 Typical High $40.74 | Professional | 56 · Pre-op care only | $22.39 | $33.88 | $40.74 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $218.78 Typical High $354.81 | Professional | 53 · Discontinued | $162.18 | $218.78 | $354.81 |
Where New York sits
The same service costs 3.0 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
$324
WI $891KY $295
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.