How much rates vary
Facilitymedian $2,455 · 10th to 90th $95 to $4,898Professionalmedian $76 · 10th to 90th $50 to $145
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 $64.57 Median $3,548.13 Typical High $9,120.11 | Facility | None | $64.57 | $3,548.13 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $125.89 | Professional | None | $46.77 | $69.18 | $125.89 |
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 $66.07 Median $79.43 Typical High $134.90 | Professional | None | $66.07 | $79.43 | $134.90 |
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 $66.07 Median $66.07 Typical High $102.33 | Professional | None | $66.07 | $66.07 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $83.18 Typical High $154.88 | Facility | None | $48.98 | $83.18 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $239.88 | Professional | None | $45.71 | $75.86 | $239.88 |
Emblem Health Setting Facility Modifier None Typical Low $44.67 Median $53.70 Typical High $165.96 | Facility | None | $44.67 | $53.70 | $165.96 |
Emblem Health Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $144.54 | Professional | None | $81.28 | $89.13 | $144.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $100.00 | Professional | None | $50.12 | $67.61 | $100.00 |
MVP Health Care Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
MVP Health Care Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $181.97 | Professional | None | $39.81 | $39.81 | $181.97 |
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 Typical Low $41.69 Median $74.13 Typical High $162.18 | Professional | None | $41.69 | $74.13 | $162.18 |
Univera Setting Facility Modifier None Typical Low $33.11 Median $64.57 Typical High $154.88 | Facility | None | $33.11 | $64.57 | $154.88 |
Univera Setting Professional Modifier None Typical Low $50.12 Median $67.61 Typical High $95.50 | Professional | None | $50.12 | $67.61 | $95.50 |
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 $23.44 Median $32.36 Typical High $46.77 | Professional | 52 · Reduced service | $23.44 | $32.36 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $12.88 Typical High $18.62 | Professional | 53 · Discontinued | $9.33 | $12.88 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $48.98 Typical High $70.79 | Professional | 54 · Surgery only | $35.48 | $48.98 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $9.77 Typical High $14.13 | Professional | 55 · Aftercare only | $7.08 | $9.77 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.46 Typical High $9.33 | Professional | 56 · Pre-op care only | $4.68 | $6.46 | $9.33 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $45.71 Typical High $74.13 | Professional | 53 · Discontinued | $34.67 | $45.71 | $74.13 |
Where New York sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 33rd of 51
$79.43
WI $200DC $64.57
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.