How much rates vary
Facilitymedian $2,630 · 10th to 90th $269 to $5,012Professionalmedian $100 · 10th to 90th $76 to $288
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 $4,265.80 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $131.83 Typical High $199.53 | Professional | None | $83.18 | $131.83 | $199.53 |
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 $81.28 Median $95.50 Typical High $257.04 | Professional | None | $81.28 | $95.50 | $257.04 |
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 $100.00 Median $100.00 Typical High $218.78 | Professional | None | $100.00 | $100.00 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $302.00 Typical High $1,479.11 | Facility | None | $158.49 | $302.00 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $144.54 Typical High $446.68 | Professional | None | $63.10 | $144.54 | $446.68 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $74.13 Typical High $245.47 | Facility | None | $34.67 | $74.13 | $245.47 |
Emblem Health Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $338.84 | Professional | None | $181.97 | $208.93 | $338.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $251.19 | Professional | None | $100.00 | $154.88 | $251.19 |
MVP Health Care Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
MVP Health Care Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $346.74 | Professional | None | $95.50 | $95.50 | $346.74 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $57.54 Median $131.83 Typical High $331.13 | Professional | None | $57.54 | $131.83 | $331.13 |
Univera Setting Facility Modifier None Typical Low $58.88 Median $151.36 Typical High $251.19 | Facility | None | $58.88 | $151.36 | $251.19 |
Univera Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $251.19 | Professional | None | $100.00 | $151.36 | $251.19 |
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 $40.74 Median $66.07 Typical High $95.50 | Professional | 52 · Reduced service | $40.74 | $66.07 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $26.30 Typical High $38.02 | Professional | 53 · Discontinued | $16.60 | $26.30 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $100.00 Typical High $144.54 | Professional | 54 · Surgery only | $61.66 | $100.00 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $19.95 Typical High $28.84 | Professional | 55 · Aftercare only | $12.30 | $19.95 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $13.18 Typical High $19.05 | Professional | 56 · Pre-op care only | $8.32 | $13.18 | $19.05 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $93.33 Typical High $162.18 | Professional | 53 · Discontinued | $70.79 | $93.33 | $162.18 |
Where New York sits
The same service costs 3.6 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· 50th of 51
$105
WI $380KY $105
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.