How much rates vary
Facilitymedian $2,754 · 10th to 90th $363 to $5,129Professionalmedian $72 · 10th to 90th $55 to $170
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 $1,318.26 Median $4,168.69 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $147.91 | Professional | None | $60.26 | $97.72 | $147.91 |
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 $57.54 Median $67.61 Typical High $154.88 | Professional | None | $57.54 | $67.61 | $154.88 |
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 $75.86 Median $75.86 Typical High $120.23 | Professional | None | $75.86 | $75.86 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,202.26 Typical High $1,659.59 | Facility | None | $457.09 | $1,202.26 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $87.10 Typical High $309.03 | Professional | None | $45.71 | $87.10 | $309.03 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $56.23 Typical High $186.21 | Facility | None | $34.67 | $56.23 | $186.21 |
Emblem Health Setting Professional Modifier None Typical Low $102.33 Median $112.20 Typical High $181.97 | Professional | None | $102.33 | $112.20 | $181.97 |
Excellus BCBS Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $134.90 | Professional | None | $60.26 | $75.86 | $134.90 |
MVP Health Care Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
MVP Health Care Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $199.53 | Professional | None | $57.54 | $57.54 | $199.53 |
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 $43.65 Median $77.62 Typical High $208.93 | Professional | None | $43.65 | $77.62 | $208.93 |
Univera Setting Facility Modifier None Typical Low $44.67 Median $75.86 Typical High $186.21 | Facility | None | $44.67 | $75.86 | $186.21 |
Univera Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $125.89 | Professional | None | $60.26 | $75.86 | $125.89 |
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 $30.20 Median $44.67 Typical High $48.98 | Professional | 52 · Reduced service | $30.20 | $44.67 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $17.78 Typical High $19.50 | Professional | 53 · Discontinued | $12.02 | $17.78 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $67.61 Typical High $74.13 | Professional | 54 · Surgery only | $45.71 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $13.49 Typical High $14.79 | Professional | 55 · Aftercare only | $9.12 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.91 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.03 | $8.91 | $9.77 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $53.70 Typical High $87.10 | Professional | 53 · Discontinued | $40.74 | $53.70 | $87.10 |
Where New York sits
The same service costs 3.5 times more in Wisconsin than in New York. 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· 51st of 51
$72.44
WI $257NY $72.44
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.