How much rates vary
Facilitymedian $1,318 · 10th to 90th $33 to $6,310Professionalmedian $120 · 10th to 90th $95 to $245
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 $1,513.56 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None (both parts) Typical Low $141.25 Median $141.25 Typical High $363.08 | Professional | None (both parts) | $141.25 | $141.25 | $363.08 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | 26 · Professional part | $125.89 | $125.89 | $141.25 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $13.18 Median $13.18 Typical High $18.20 | Professional | TC · Technical part | $13.18 | $13.18 | $18.20 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $95.50 Median $112.20 Typical High $213.80 | Professional | None (both parts) | $95.50 | $112.20 | $213.80 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $87.10 Median $102.33 Typical High $190.55 | Professional | 26 · Professional part | $87.10 | $102.33 | $190.55 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $8.91 Median $10.47 Typical High $24.55 | Professional | TC · Technical part | $8.91 | $10.47 | $24.55 |
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 (both parts) Typical Low $18.62 Median $154.88 Typical High $173.78 | Professional | None (both parts) | $18.62 | $154.88 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $19.50 Median $36.31 Typical High $218.78 | Facility | None | $19.50 | $36.31 | $218.78 |
Cigna Setting Professional Modifier None (both parts) Typical Low $104.71 Median $147.91 Typical High $489.78 | Professional | None (both parts) | $104.71 | $147.91 | $489.78 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $91.20 Median $131.83 Typical High $436.52 | Professional | 26 · Professional part | $91.20 | $131.83 | $436.52 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $12.88 Median $15.85 Typical High $57.54 | Professional | TC · Technical part | $12.88 | $15.85 | $57.54 |
Emblem Health Setting Facility Modifier None Typical Low $10.00 Median $17.78 Typical High $58.88 | Facility | None | $10.00 | $17.78 | $58.88 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $131.83 Median $151.36 Typical High $245.47 | Professional | None (both parts) | $131.83 | $151.36 | $245.47 |
Emblem Health Setting Professional Modifier 26 · Professional part Typical Low $114.82 Median $131.83 Typical High $213.80 | Professional | 26 · Professional part | $114.82 | $131.83 | $213.80 |
Emblem Health Setting Professional Modifier TC · Technical part Typical Low $17.78 Median $18.62 Typical High $30.90 | Professional | TC · Technical part | $17.78 | $18.62 | $30.90 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $83.18 Median $120.23 Typical High $177.83 | Professional | None (both parts) | $83.18 | $120.23 | $177.83 |
Excellus BCBS Setting Professional Modifier 26 · Professional part Typical Low $72.44 Median $104.71 Typical High $154.88 | Professional | 26 · Professional part | $72.44 | $104.71 | $154.88 |
Excellus BCBS Setting Professional Modifier TC · Technical part Typical Low $9.77 Median $13.80 Typical High $21.88 | Professional | TC · Technical part | $9.77 | $13.80 | $21.88 |
MVP Health Care Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $131.83 Median $131.83 Typical High $295.12 | Professional | None (both parts) | $131.83 | $131.83 | $295.12 |
MVP Health Care Setting Professional Modifier 26 · Professional part Typical Low $112.20 Median $144.54 Typical High $218.78 | Professional | 26 · Professional part | $112.20 | $144.54 | $218.78 |
MVP Health Care Setting Professional Modifier TC · Technical part Typical Low $12.30 Median $16.60 Typical High $28.84 | Professional | TC · Technical part | $12.30 | $16.60 | $28.84 |
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 (both parts) Typical Low $91.20 Median $128.82 Typical High $323.59 | Professional | None (both parts) | $91.20 | $128.82 | $323.59 |
United Setting Professional Modifier 26 · Professional part Typical Low $79.43 Median $114.82 Typical High $295.12 | Professional | 26 · Professional part | $79.43 | $114.82 | $295.12 |
United Setting Professional Modifier TC · Technical part Typical Low $10.23 Median $13.18 Typical High $34.67 | Professional | TC · Technical part | $10.23 | $13.18 | $34.67 |
Univera Setting Facility Modifier None Typical Low $70.79 Median $107.15 Typical High $380.19 | Facility | None | $70.79 | $107.15 | $380.19 |
Univera Setting Facility Modifier 26 · Professional part Typical Low $61.66 Median $85.11 Typical High $363.08 | Facility | 26 · Professional part | $61.66 | $85.11 | $363.08 |
Univera Setting Facility Modifier TC · Technical part Typical Low $8.32 Median $16.98 Typical High $45.71 | Facility | TC · Technical part | $8.32 | $16.98 | $45.71 |
Univera Setting Professional Modifier None (both parts) Typical Low $83.18 Median $120.23 Typical High $173.78 | Professional | None (both parts) | $83.18 | $120.23 | $173.78 |
Univera Setting Professional Modifier 26 · Professional part Typical Low $72.44 Median $104.71 Typical High $154.88 | Professional | 26 · Professional part | $72.44 | $104.71 | $154.88 |
Univera Setting Professional Modifier TC · Technical part Typical Low $9.77 Median $13.80 Typical High $21.88 | Professional | TC · Technical part | $9.77 | $13.80 | $21.88 |
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 $70.79 Median $70.79 Typical High $79.43 | Professional | 52 · Reduced service | $70.79 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $31.62 | Professional | 53 · Discontinued | $28.18 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $120.23 | Professional | 54 · Surgery only | $104.71 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $23.99 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $15.85 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $15.85 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $81.28 Typical High $123.03 | Professional | 53 · Discontinued | $63.10 | $81.28 | $123.03 |
Where New York sits
The same service costs 4.7 times more in Alaska 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.
New York· 49th of 51
$120
AK $490AL $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.