How much rates vary
Facilitymedian $2,630 · 10th to 90th $363 to $5,129Professionalmedian $174 · 10th to 90th $135 to $372
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 $1,348.96 Median $4,365.16 Typical High $8,128.31 | Facility | None | $1,348.96 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $562.34 | Professional | None | $169.82 | $218.78 | $562.34 |
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 $338.84 | Professional | None | $141.25 | $169.82 | $338.84 |
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 $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $316.23 Typical High $575.44 | Facility | None | $223.87 | $316.23 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $707.95 | Professional | None | $218.78 | $251.19 | $707.95 |
Emblem Health Setting Facility Modifier None Typical Low $93.33 Median $177.83 Typical High $630.96 | Facility | None | $93.33 | $177.83 | $630.96 |
Emblem Health Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $346.74 | Professional | None | $190.55 | $208.93 | $346.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $229.09 | Professional | None | $107.15 | $147.91 | $229.09 |
MVP Health Care Setting Facility Modifier None Typical Low $194.98 Median $3,235.94 Typical High $4,365.16 | Facility | None | $194.98 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $467.74 | Professional | None | $269.15 | $269.15 | $467.74 |
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 $138.04 Median $218.78 Typical High $478.63 | Professional | None | $138.04 | $218.78 | $478.63 |
Univera Setting Facility Modifier None Typical Low $151.36 Median $165.96 Typical High $588.84 | Facility | None | $151.36 | $165.96 | $588.84 |
Univera Setting Professional Modifier None Typical Low $107.15 Median $147.91 Typical High $208.93 | Professional | None | $107.15 | $147.91 | $208.93 |
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 $85.11 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $85.11 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $33.88 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $162.18 Typical High $162.18 | Professional | 54 · Surgery only | $125.89 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $25.12 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.98 | $21.88 | $21.88 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $123.03 Typical High $177.83 | Professional | 53 · Discontinued | $89.13 | $123.03 | $177.83 |
Where New York sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 50th of 51
$182
AK $562TX $178
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.