How much rates vary
Facilitymedian $2,630 · 10th to 90th $417 to $5,012Professionalmedian $389 · 10th to 90th $309 to $832
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 $1,318.26 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $380.19 Typical High $467.74 | Professional | None | $295.12 | $380.19 | $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 $323.59 Median $371.54 Typical High $776.25 | Professional | None | $323.59 | $371.54 | $776.25 |
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 $426.58 Median $426.58 Typical High $562.34 | Professional | None | $426.58 | $426.58 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $436.52 Typical High $1,479.11 | Facility | None | $229.09 | $436.52 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $1,348.96 | Professional | None | $380.19 | $489.78 | $1,348.96 |
Emblem Health Setting Facility Modifier None Typical Low $100.00 Median $331.13 Typical High $1,096.48 | Facility | None | $100.00 | $331.13 | $1,096.48 |
Emblem Health Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $851.14 | Professional | None | $457.09 | $524.81 | $851.14 |
Excellus BCBS Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $512.86 | Professional | None | $263.03 | $371.54 | $512.86 |
MVP Health Care Setting Facility Modifier None Typical Low $354.81 Median $3,235.94 Typical High $4,365.16 | Facility | None | $354.81 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $1,023.29 | Professional | None | $676.08 | $707.95 | $1,023.29 |
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 $269.15 Median $436.52 Typical High $977.24 | Professional | None | $269.15 | $436.52 | $977.24 |
Univera Setting Facility Modifier None Typical Low $257.04 Median $371.54 Typical High $1,122.02 | Facility | None | $257.04 | $371.54 | $1,122.02 |
Univera Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $489.78 | Professional | None | $263.03 | $371.54 | $489.78 |
5 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 $144.54 Median $190.55 Typical High $234.42 | Professional | 52 · Reduced service | $144.54 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $75.86 Typical High $95.50 | Professional | 53 · Discontinued | $58.88 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $288.40 Typical High $354.81 | Professional | 54 · Surgery only | $218.78 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $57.54 Typical High $70.79 | Professional | 55 · Aftercare only | $43.65 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $38.02 Typical High $46.77 | Professional | 56 · Pre-op care only | $29.51 | $38.02 | $46.77 |
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· 38th of 51
$407
AK $977KY $339
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.