How much rates vary
Facilitymedian $2,512 · 10th to 90th $178 to $5,012Professionalmedian $158 · 10th to 90th $93 to $282
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 $93.33 Median $3,090.30 Typical High $7,762.47 | Facility | None | $93.33 | $3,090.30 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $138.04 Typical High $251.19 | Professional | None | $74.13 | $138.04 | $251.19 |
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 $141.25 Median $169.82 Typical High $281.84 | Professional | None | $141.25 | $169.82 | $281.84 |
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 $104.71 Median $104.71 Typical High $218.78 | Professional | None | $104.71 | $104.71 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $275.42 Typical High $1,479.11 | Facility | None | $141.25 | $275.42 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $162.18 Typical High $446.68 | Professional | None | $77.62 | $162.18 | $446.68 |
Emblem Health Setting Facility Modifier None Typical Low $74.13 Median $107.15 Typical High $281.84 | Facility | None | $74.13 | $107.15 | $281.84 |
Emblem Health Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $331.13 | Professional | None | $165.96 | $194.98 | $331.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $194.98 | Professional | None | $100.00 | $144.54 | $194.98 |
Highmark BCBS Setting Facility Modifier None Typical Low $275.42 Median $1,445.44 Typical High $2,570.40 | Facility | None | $275.42 | $1,445.44 | $2,570.40 |
Highmark BCBS Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
MVP Health Care Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
MVP Health Care Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $363.08 | Professional | None | $114.82 | $114.82 | $363.08 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,819.70 Typical High $4,897.79 | Facility | None | $537.03 | $1,819.70 | $4,897.79 |
United Setting Professional Modifier None Typical Low $67.61 Median $141.25 Typical High $323.59 | Professional | None | $67.61 | $141.25 | $323.59 |
Univera Setting Facility Modifier None Typical Low $54.95 Median $144.54 Typical High $239.88 | Facility | None | $54.95 | $144.54 | $239.88 |
Univera Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $186.21 | Professional | None | $100.00 | $144.54 | $186.21 |
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 $37.15 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $37.15 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $27.54 Typical High $31.62 | Professional | 53 · Discontinued | $14.79 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $102.33 Typical High $120.23 | Professional | 54 · Surgery only | $54.95 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $20.42 Typical High $23.99 | Professional | 55 · Aftercare only | $10.96 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $13.80 Typical High $15.85 | Professional | 56 · Pre-op care only | $7.41 | $13.80 | $15.85 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $97.72 Typical High $154.88 | Professional | 53 · Discontinued | $72.44 | $97.72 | $154.88 |
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· 23rd of 51
$158
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.