How much rates vary
Facilitymedian $2,570 · 10th to 90th $229 to $5,129Professionalmedian $135 · 10th to 90th $100 to $257
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 $194.98 Median $4,168.69 Typical High $8,128.31 | Facility | None | $194.98 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $239.88 | Professional | None | $89.13 | $123.03 | $239.88 |
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 $117.49 Median $138.04 Typical High $234.42 | Professional | None | $117.49 | $138.04 | $234.42 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $181.97 | Professional | None | $125.89 | $125.89 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $194.98 Typical High $1,479.11 | Facility | None | $104.71 | $194.98 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $416.87 | Professional | None | $91.20 | $134.90 | $416.87 |
Emblem Health Setting Facility Modifier None Typical Low $97.72 Median $213.80 Typical High $371.54 | Facility | None | $97.72 | $213.80 | $371.54 |
Emblem Health Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $281.84 | Professional | None | $151.36 | $173.78 | $281.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $177.83 | Professional | None | $89.13 | $114.82 | $177.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $1,023.29 | Facility | None | $524.81 | $524.81 | $1,023.29 |
MVP Health Care Setting Facility Modifier None Typical Low $93.33 Median $5,888.44 Typical High $8,511.38 | Facility | None | $93.33 | $5,888.44 | $8,511.38 |
MVP Health Care Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $309.03 | Professional | None | $128.82 | $128.82 | $309.03 |
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 $81.28 Median $141.25 Typical High $295.12 | Professional | None | $81.28 | $141.25 | $295.12 |
Univera Setting Facility Modifier None Typical Low $66.07 Median $114.82 Typical High $338.84 | Facility | None | $66.07 | $114.82 | $338.84 |
Univera Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $173.78 | Professional | None | $89.13 | $114.82 | $173.78 |
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 $44.67 Median $57.54 Typical High $74.13 | Professional | 52 · Reduced service | $44.67 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $22.91 Typical High $29.51 | Professional | 53 · Discontinued | $17.78 | $22.91 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $87.10 Typical High $109.65 | Professional | 54 · Surgery only | $66.07 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $17.38 Typical High $21.88 | Professional | 55 · Aftercare only | $13.49 | $17.38 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.48 Typical High $14.79 | Professional | 56 · Pre-op care only | $8.91 | $11.48 | $14.79 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $85.11 Typical High $134.90 | Professional | 53 · Discontinued | $63.10 | $85.11 | $134.90 |
Where New York sits
The same service costs 3.3 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· 35th of 51
$138
WI $372KY $112
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.