How much rates vary
Facilitymedian $2,754 · 10th to 90th $331 to $5,129Professionalmedian $35 · 10th to 90th $27 to $79
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 $54.95 Median $3,890.45 Typical High $8,128.31 | Facility | None | $54.95 | $3,890.45 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $39.81 Typical High $79.43 | Professional | None | $29.51 | $39.81 | $79.43 |
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 $26.92 Median $31.62 Typical High $70.79 | Professional | None | $26.92 | $31.62 | $70.79 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $16.98 Median $19.95 Typical High $44.67 | Professional | 62 · Two surgeons | $16.98 | $19.95 | $44.67 |
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 $41.69 Median $41.69 Typical High $54.95 | Professional | None | $41.69 | $41.69 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,445.44 Typical High $1,862.09 | Facility | None | $446.68 | $1,445.44 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $39.81 Typical High $131.83 | Professional | None | $30.20 | $39.81 | $131.83 |
Emblem Health Setting Facility Modifier None Typical Low $30.20 Median $38.90 Typical High $104.71 | Facility | None | $30.20 | $38.90 | $104.71 |
Emblem Health Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $79.43 | Professional | None | $44.67 | $48.98 | $79.43 |
Excellus BCBS Setting Professional Modifier None Typical Low $25.12 Median $35.48 Typical High $53.70 | Professional | None | $25.12 | $35.48 | $53.70 |
Highmark BCBS Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $1,778.28 | Facility | None | $398.11 | $398.11 | $1,778.28 |
Highmark BCBS Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
MVP Health Care Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
MVP Health Care Setting Professional Modifier None Typical Low $58.88 Median $70.79 Typical High $97.72 | Professional | None | $58.88 | $70.79 | $97.72 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $26.30 Median $44.67 Typical High $93.33 | Professional | None | $26.30 | $44.67 | $93.33 |
Univera Setting Facility Modifier None Typical Low $20.89 Median $33.11 Typical High $120.23 | Facility | None | $20.89 | $33.11 | $120.23 |
Univera Setting Professional Modifier None Typical Low $25.12 Median $35.48 Typical High $50.12 | Professional | None | $25.12 | $35.48 | $50.12 |
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 $14.79 Median $18.62 Typical High $23.44 | Professional | 52 · Reduced service | $14.79 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $7.41 Typical High $9.33 | Professional | 53 · Discontinued | $5.89 | $7.41 | $9.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $28.18 Typical High $35.48 | Professional | 54 · Surgery only | $22.39 | $28.18 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $5.62 Typical High $7.08 | Professional | 55 · Aftercare only | $4.47 | $5.62 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.72 Typical High $4.68 | Professional | 56 · Pre-op care only | $2.95 | $3.72 | $4.68 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $26.30 Typical High $38.02 | Professional | 53 · Discontinued | $19.50 | $26.30 | $38.02 |
Where New York sits
The same service costs 3.3 times more in Alaska 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
$37.15
AK $117KY $35.48
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.