How much rates vary
Facilitymedian $2,570 · 10th to 90th $288 to $5,012Professionalmedian $191 · 10th to 90th $145 to $437
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 $239.88 Median $3,890.45 Typical High $8,128.31 | Facility | None | $239.88 | $3,890.45 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $407.38 | Professional | None | $158.49 | $239.88 | $407.38 |
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 $151.36 Median $177.83 Typical High $398.11 | Professional | None | $151.36 | $177.83 | $398.11 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $309.03 | Professional | None | $186.21 | $186.21 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $363.08 Typical High $1,479.11 | Facility | None | $190.55 | $363.08 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $218.78 Typical High $691.83 | Professional | None | $117.49 | $218.78 | $691.83 |
Emblem Health Setting Facility Modifier None Typical Low $151.36 Median $204.17 Typical High $537.03 | Facility | None | $151.36 | $204.17 | $537.03 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $501.19 | Professional | None | $275.42 | $316.23 | $501.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $316.23 | Professional | None | $147.91 | $223.87 | $316.23 |
Highmark BCBS Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
MVP Health Care Setting Facility Modifier None Typical Low $147.91 Median $3,235.94 Typical High $4,365.16 | Facility | None | $147.91 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $524.81 | Professional | None | $223.87 | $223.87 | $524.81 |
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 $107.15 Median $199.53 Typical High $537.03 | Professional | None | $107.15 | $199.53 | $537.03 |
Univera Setting Facility Modifier None Typical Low $77.62 Median $199.53 Typical High $407.38 | Facility | None | $77.62 | $199.53 | $407.38 |
Univera Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $316.23 | Professional | None | $147.91 | $204.17 | $316.23 |
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 $79.43 Median $109.65 Typical High $144.54 | Professional | 52 · Reduced service | $79.43 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $43.65 Typical High $57.54 | Professional | 53 · Discontinued | $31.62 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $165.96 Typical High $213.80 | Professional | 54 · Surgery only | $120.23 | $165.96 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.11 Typical High $42.66 | Professional | 55 · Aftercare only | $23.99 | $33.11 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.88 Typical High $28.84 | Professional | 56 · Pre-op care only | $15.85 | $21.88 | $28.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $141.25 Typical High $223.87 | Professional | 53 · Discontinued | $107.15 | $141.25 | $223.87 |
Where New York sits
The same service costs 8.8 times more in New York than in Alabama. 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.
Physician feeFacility fee
NY $2,761AL $314
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.