How much rates vary
Facilitymedian $2,138 · 10th to 90th $98 to $4,898Professionalmedian $74 · 10th to 90th $56 to $170
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 $50.12 Median $1,737.80 Typical High $7,585.78 | Facility | None | $50.12 | $1,737.80 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $91.20 Typical High $173.78 | Professional | None | $47.86 | $91.20 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $42.66 Median $107.15 Typical High $158.49 | Professional | None | $42.66 | $107.15 | $158.49 |
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 $58.88 Median $70.79 Typical High $104.71 | Professional | None | $58.88 | $70.79 | $104.71 |
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 $72.44 Median $72.44 Typical High $147.91 | Professional | None | $72.44 | $72.44 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $100.00 Typical High $1,096.48 | Facility | None | $77.62 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $112.20 Typical High $288.40 | Professional | None | $48.98 | $112.20 | $288.40 |
Emblem Health Setting Facility Modifier None Typical Low $50.12 Median $89.13 Typical High $186.21 | Facility | None | $50.12 | $89.13 | $186.21 |
Emblem Health Setting Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $213.80 | Professional | None | $114.82 | $128.82 | $213.80 |
Excellus BCBS Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Excellus BCBS Setting Professional Modifier None Typical Low $64.57 Median $85.11 Typical High $154.88 | Professional | None | $64.57 | $85.11 | $154.88 |
Highmark BCBS Setting Facility Modifier None Typical Low $100.00 Median $776.25 Typical High $3,548.13 | Facility | None | $100.00 | $776.25 | $3,548.13 |
Highmark BCBS Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $269.15 | Professional | None | $123.03 | $223.87 | $269.15 |
MVP Health Care Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
MVP Health Care Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $223.87 | Professional | None | $128.82 | $151.36 | $223.87 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $45.71 Median $95.50 Typical High $208.93 | Professional | None | $45.71 | $95.50 | $208.93 |
Univera Setting Facility Modifier None Typical Low $37.15 Median $208.93 Typical High $251.19 | Facility | None | $37.15 | $208.93 | $251.19 |
Univera Setting Professional Modifier None Typical Low $48.98 Median $85.11 Typical High $141.25 | Professional | None | $48.98 | $85.11 | $141.25 |
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 $27.54 Median $45.71 Typical High $48.98 | Professional | 52 · Reduced service | $27.54 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $18.20 Typical High $19.50 | Professional | 53 · Discontinued | $10.96 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $67.61 Typical High $74.13 | Professional | 54 · Surgery only | $40.74 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $13.49 Typical High $14.79 | Professional | 55 · Aftercare only | $8.13 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $9.12 Typical High $9.77 | Professional | 56 · Pre-op care only | $5.50 | $9.12 | $9.77 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $60.26 Typical High $109.65 | Professional | 53 · Discontinued | $45.71 | $60.26 | $109.65 |
Where New York sits
The same service costs 3.2 times more in Alaska than in New York. 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· 51st of 51
$77.62
AK $251NY $77.62
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.