How much rates vary
Facilitymedian $2,570 · 10th to 90th $229 to $5,012Professionalmedian $178 · 10th to 90th $129 to $347
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 $158.49 Median $3,801.89 Typical High $9,772.37 | Facility | None | $158.49 | $3,801.89 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $346.74 | Professional | None | $134.90 | $173.78 | $346.74 |
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 $147.91 Median $177.83 Typical High $309.03 | Professional | None | $147.91 | $177.83 | $309.03 |
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 $181.97 Median $181.97 Typical High $218.78 | Professional | None | $181.97 | $181.97 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $141.25 Typical High $257.04 | Facility | None | $89.13 | $141.25 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $660.69 | Professional | None | $162.18 | $190.55 | $660.69 |
Emblem Health Setting Facility Modifier None Typical Low $141.25 Median $239.88 Typical High $489.78 | Facility | None | $141.25 | $239.88 | $489.78 |
Emblem Health Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $363.08 | Professional | None | $181.97 | $208.93 | $363.08 |
Excellus BCBS Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $204.17 | Professional | None | $93.33 | $151.36 | $204.17 |
MVP Health Care Setting Facility Modifier None Typical Low $144.54 Median $3,235.94 Typical High $4,365.16 | Facility | None | $144.54 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $269.15 Median $275.42 Typical High $407.38 | Professional | None | $269.15 | $275.42 | $407.38 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $4,897.79 | Facility | None | $549.54 | $1,862.09 | $4,897.79 |
United Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $389.05 | Professional | None | $112.20 | $177.83 | $389.05 |
Univera Setting Facility Modifier None Typical Low $109.65 Median $144.54 Typical High $467.74 | Facility | None | $109.65 | $144.54 | $467.74 |
Univera Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $194.98 | Professional | None | $93.33 | $144.54 | $194.98 |
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 $63.10 Median $79.43 Typical High $93.33 | Professional | 52 · Reduced service | $63.10 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $32.36 Typical High $37.15 | Professional | 53 · Discontinued | $25.12 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $120.23 Typical High $141.25 | Professional | 54 · Surgery only | $95.50 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $23.99 Typical High $28.18 | Professional | 55 · Aftercare only | $19.05 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.85 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.59 | $15.85 | $18.62 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $107.15 Typical High $158.49 | Professional | 53 · Discontinued | $77.62 | $107.15 | $158.49 |
Where New York sits
The same service costs 2.9 times more in Alaska 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· 28th of 51
$182
AK $417KY $145
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.