How much rates vary
Facilitymedian $3,020 · 10th to 90th $135 to $7,079Professionalmedian $100 · 10th to 90th $79 to $263
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 $97.72 Median $125.89 Typical High $302.00 | Facility | None | $97.72 | $125.89 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $190.55 | Professional | None | $97.72 | $125.89 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $199.53 | Professional | None | $83.18 | $97.72 | $199.53 |
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 $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,884.03 Typical High $5,623.41 | Facility | None | $1,000.00 | $2,884.03 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $501.19 | Professional | None | $125.89 | $144.54 | $501.19 |
Emblem Health Setting Facility Modifier None Typical Low $114.82 Median $354.81 Typical High $645.65 | Facility | None | $114.82 | $354.81 | $645.65 |
Emblem Health Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $204.17 | Professional | None | $107.15 | $123.03 | $204.17 |
Excellus BCBS Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $131.83 | Professional | None | $63.10 | $83.18 | $131.83 |
Highmark BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $4,168.69 Typical High $11,220.18 | Facility | None | $1,698.24 | $4,168.69 | $11,220.18 |
MVP Health Care Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
MVP Health Care Setting Professional Modifier None Typical Low $169.82 Median $501.19 Typical High $501.19 | Professional | None | $169.82 | $501.19 | $501.19 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,585.78 | Facility | None | $1,122.02 | $2,754.23 | $7,585.78 |
United Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $281.84 | Professional | None | $81.28 | $125.89 | $281.84 |
Univera Setting Facility Modifier None Typical Low $35.48 Median $87.10 Typical High $331.13 | Facility | None | $35.48 | $87.10 | $331.13 |
Univera Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $123.03 | Professional | None | $63.10 | $87.10 | $123.03 |
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 $48.98 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $48.98 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $19.50 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $14.45 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.77 | $12.59 | $12.59 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $70.79 Typical High $102.33 | Professional | 53 · Discontinued | $51.29 | $70.79 | $102.33 |
Where New York sits
The same service costs 7.9 times more in Kansas 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
$105
KS $832NY $105
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.