How much rates vary
Facilitymedian $2,570 · 10th to 90th $355 to $5,012Professionalmedian $200 · 10th to 90th $151 to $417
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 $1,621.81 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,621.81 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $467.74 | Professional | None | $190.55 | $245.47 | $467.74 |
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 $162.18 Median $190.55 Typical High $380.19 | Professional | None | $162.18 | $190.55 | $380.19 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $288.40 Typical High $575.44 | Facility | None | $100.00 | $288.40 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $794.33 | Professional | None | $245.47 | $281.84 | $794.33 |
Emblem Health Setting Facility Modifier None Typical Low $218.78 Median $323.59 Typical High $758.58 | Facility | None | $218.78 | $323.59 | $758.58 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $389.05 | Professional | None | $204.17 | $234.42 | $389.05 |
Excellus BCBS Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $257.04 | Professional | None | $120.23 | $165.96 | $257.04 |
MVP Health Care Setting Facility Modifier None Typical Low $218.78 Median $3,235.94 Typical High $4,365.16 | Facility | None | $218.78 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $524.81 | Professional | None | $302.00 | $302.00 | $524.81 |
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 $154.88 Median $245.47 Typical High $549.54 | Professional | None | $154.88 | $245.47 | $549.54 |
Univera Setting Facility Modifier None Typical Low $169.82 Median $190.55 Typical High $776.25 | Facility | None | $169.82 | $190.55 | $776.25 |
Univera Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $239.88 | Professional | None | $120.23 | $165.96 | $239.88 |
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 $95.50 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $95.50 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $38.02 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $186.21 Typical High $186.21 | Professional | 54 · Surgery only | $141.25 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $28.84 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $19.05 | $24.55 | $24.55 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $138.04 Typical High $199.53 | Professional | 53 · Discontinued | $102.33 | $138.04 | $199.53 |
Where New York sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 48th of 51
$204
AK $631UT $195
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.