How much rates vary
Facilitymedian $2,291 · 10th to 90th $100 to $4,898Professionalmedian $110 · 10th to 90th $79 to $214
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 $75.86 Median $2,290.87 Typical High $7,585.78 | Facility | None | $75.86 | $2,290.87 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $107.15 Typical High $177.83 | Professional | None | $67.61 | $107.15 | $177.83 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
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 $109.65 Typical High $199.53 | Professional | None | $93.33 | $109.65 | $199.53 |
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 $91.20 Median $91.20 Typical High $144.54 | Professional | None | $91.20 | $91.20 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $100.00 Typical High $213.80 | Facility | None | $69.18 | $100.00 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $107.15 Typical High $380.19 | Professional | None | $66.07 | $107.15 | $380.19 |
Emblem Health Setting Facility Modifier None Typical Low $50.12 Median $67.61 Typical High $213.80 | Facility | None | $50.12 | $67.61 | $213.80 |
Emblem Health Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $223.87 | Professional | None | $117.49 | $158.49 | $223.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $141.25 | Professional | None | $67.61 | $93.33 | $141.25 |
Highmark BCBS Setting Facility Modifier None Typical Low $50.12 Median $602.56 Typical High $2,754.23 | Facility | None | $50.12 | $602.56 | $2,754.23 |
Highmark BCBS Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $251.19 | Professional | None | $213.80 | $213.80 | $251.19 |
MVP Health Care Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
MVP Health Care Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $251.19 | Professional | None | $154.88 | $186.21 | $251.19 |
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 $57.54 Median $107.15 Typical High $234.42 | Professional | None | $57.54 | $107.15 | $234.42 |
Univera Setting Facility Modifier None Typical Low $45.71 Median $89.13 Typical High $302.00 | Facility | None | $45.71 | $89.13 | $302.00 |
Univera Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $128.82 | Professional | None | $67.61 | $93.33 | $128.82 |
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 $43.65 Median $53.70 Typical High $67.61 | Professional | 52 · Reduced service | $43.65 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $21.88 Typical High $26.92 | Professional | 53 · Discontinued | $17.38 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $81.28 Typical High $102.33 | Professional | 54 · Surgery only | $64.57 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $16.22 Typical High $20.42 | Professional | 55 · Aftercare only | $13.18 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.96 Typical High $13.49 | Professional | 56 · Pre-op care only | $8.71 | $10.96 | $13.49 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $66.07 Typical High $102.33 | Professional | 53 · Discontinued | $48.98 | $66.07 | $102.33 |
Where New York sits
The same service costs 3.0 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· 36th of 51
$110
WI $282KY $93.33
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.