How much rates vary
Facilitymedian $2,630 · 10th to 90th $135 to $5,129Professionalmedian $110 · 10th to 90th $79 to $200
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 $91.20 Median $3,548.13 Typical High $7,762.47 | Facility | None | $91.20 | $3,548.13 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $91.20 Typical High $186.21 | Professional | None | $64.57 | $91.20 | $186.21 |
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 $93.33 Median $112.20 Typical High $186.21 | Professional | None | $93.33 | $112.20 | $186.21 |
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 $93.33 Median $93.33 Typical High $144.54 | Professional | None | $93.33 | $93.33 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $151.36 Typical High $1,479.11 | Facility | None | $81.28 | $151.36 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $107.15 Typical High $346.74 | Professional | None | $67.61 | $107.15 | $346.74 |
Emblem Health Setting Facility Modifier None Typical Low $63.10 Median $77.62 Typical High $239.88 | Facility | None | $63.10 | $77.62 | $239.88 |
Emblem Health Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $218.78 | Professional | None | $114.82 | $131.83 | $218.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $144.54 | Professional | None | $69.18 | $100.00 | $144.54 |
MVP Health Care Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
MVP Health Care Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $239.88 | Professional | None | $120.23 | $120.23 | $239.88 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $4,897.79 | Facility | None | $549.54 | $1,862.09 | $4,897.79 |
United Setting Professional Modifier None Typical Low $58.88 Median $104.71 Typical High $223.87 | Professional | None | $58.88 | $104.71 | $223.87 |
Univera Setting Facility Modifier None Typical Low $47.86 Median $91.20 Typical High $245.47 | Facility | None | $47.86 | $91.20 | $245.47 |
Univera Setting Professional Modifier None Typical Low $69.18 Median $91.20 Typical High $134.90 | Professional | None | $69.18 | $91.20 | $134.90 |
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 $32.36 Median $45.71 Typical High $56.23 | Professional | 52 · Reduced service | $32.36 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $18.20 Typical High $22.39 | Professional | 53 · Discontinued | $12.88 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $67.61 Typical High $83.18 | Professional | 54 · Surgery only | $48.98 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.49 Typical High $16.60 | Professional | 55 · Aftercare only | $9.77 | $13.49 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $9.12 Typical High $11.22 | Professional | 56 · Pre-op care only | $6.46 | $9.12 | $11.22 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $64.57 Typical High $104.71 | Professional | 53 · Discontinued | $48.98 | $64.57 | $104.71 |
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· 26th of 51
$112
WI $282KY $77.62
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.