How much rates vary
Facilitymedian $2,455 · 10th to 90th $148 to $4,467Professionalmedian $58 · 10th to 90th $31 to $107
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 $22.91 Median $51.29 Typical High $131.83 | Facility | None | $22.91 | $51.29 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $52.48 Typical High $69.18 | Professional | None | $29.51 | $52.48 | $69.18 |
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 $51.29 Median $63.10 Typical High $107.15 | Professional | None | $51.29 | $63.10 | $107.15 |
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 $37.15 Median $37.15 Typical High $83.18 | Professional | None | $37.15 | $37.15 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $100.00 Typical High $1,096.48 | Facility | None | $39.81 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $61.66 Typical High $162.18 | Professional | None | $27.54 | $61.66 | $162.18 |
Emblem Health Setting Facility Modifier None Typical Low $26.30 Median $35.48 Typical High $91.20 | Facility | None | $26.30 | $35.48 | $91.20 |
Emblem Health Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $109.65 | Professional | None | $57.54 | $66.07 | $109.65 |
Excellus BCBS Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $72.44 | Professional | None | $38.02 | $50.12 | $72.44 |
MVP Health Care Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
MVP Health Care Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $134.90 | Professional | None | $30.20 | $30.20 | $134.90 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,148.15 Typical High $4,365.16 | Facility | None | $309.03 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $23.99 Median $52.48 Typical High $120.23 | Professional | None | $23.99 | $52.48 | $120.23 |
Univera Setting Facility Modifier None Typical Low $18.62 Median $54.95 Typical High $114.82 | Facility | None | $18.62 | $54.95 | $114.82 |
Univera Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $69.18 | Professional | None | $38.02 | $50.12 | $69.18 |
5 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 $26.30 Typical High $27.54 | Professional | 52 · Reduced service | $14.79 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $10.47 Typical High $10.96 | Professional | 53 · Discontinued | $5.89 | $10.47 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $7.76 Typical High $8.32 | Professional | 55 · Aftercare only | $4.47 | $7.76 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $5.25 Typical High $5.50 | Professional | 56 · Pre-op care only | $2.95 | $5.25 | $5.50 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $36.31 Typical High $57.54 | Professional | 53 · Discontinued | $26.92 | $36.31 | $57.54 |
Where New York sits
The same service costs 3.5 times more in Wisconsin than in Utah. 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· 23rd of 51
$58.88
WI $135UT $38.02
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.