How much rates vary
Facilitymedian $3,802 · 10th to 90th $776 to $9,120Professionalmedian $71 · 10th to 90th $56 to $155
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 $4,365.16 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $204.17 | Professional | None | $87.10 | $87.10 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $131.83 | Professional | None | $60.26 | $70.79 | $131.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $104.71 Typical High $199.53 | Professional | 50 · Both sides | $89.13 | $104.71 | $199.53 |
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 $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,089.30 Typical High $4,073.80 | Facility | None | $954.99 | $2,089.30 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $93.33 Typical High $323.59 | Professional | None | $64.57 | $93.33 | $323.59 |
Emblem Health Setting Facility Modifier None Typical Low $75.86 Median $93.33 Typical High $275.42 | Facility | None | $75.86 | $93.33 | $275.42 |
Emblem Health Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $134.90 | Professional | None | $72.44 | $81.28 | $134.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $50.12 Median $64.57 Typical High $107.15 | Professional | None | $50.12 | $64.57 | $107.15 |
MVP Health Care Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | None | $81.28 | $81.28 | $81.28 |
MVP Health Care Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $181.97 | Professional | None | $97.72 | $97.72 | $181.97 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,344.23 Typical High $6,606.93 | Facility | None | $831.76 | $2,344.23 | $6,606.93 |
United Setting Professional Modifier None Typical Low $51.29 Median $77.62 Typical High $204.17 | Professional | None | $51.29 | $77.62 | $204.17 |
Univera Setting Facility Modifier None Typical Low $42.66 Median $66.07 Typical High $239.88 | Facility | None | $42.66 | $66.07 | $239.88 |
Univera Setting Professional Modifier None Typical Low $50.12 Median $64.57 Typical High $107.15 | Professional | None | $50.12 | $64.57 | $107.15 |
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 $43.65 Median $43.65 Typical High $47.86 | Professional | 52 · Reduced service | $43.65 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $19.05 | Professional | 53 · Discontinued | $17.38 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $66.07 Typical High $72.44 | Professional | 54 · Surgery only | $66.07 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $14.45 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $9.55 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $50.12 Typical High $75.86 | Professional | 53 · Discontinued | $38.02 | $50.12 | $75.86 |
Where New York sits
The same service costs 11.2 times more in Tennessee 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
$74.13
TN $832NY $74.13
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.