How much rates vary
Facilitymedian $3,631 · 10th to 90th $776 to $8,913Professionalmedian $126 · 10th to 90th $100 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 $302.00 Median $5,623.41 Typical High $11,481.54 | Facility | None | $302.00 | $5,623.41 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $162.18 Typical High $389.05 | Professional | None | $125.89 | $162.18 | $389.05 |
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 $100.00 Median $117.49 Typical High $251.19 | Professional | None | $100.00 | $117.49 | $251.19 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $5,888.44 | Facility | None | $1,445.44 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $524.81 | Professional | None | $162.18 | $190.55 | $524.81 |
Emblem Health Setting Facility Modifier None Typical Low $147.91 Median $218.78 Typical High $501.19 | Facility | None | $147.91 | $218.78 | $501.19 |
Emblem Health Setting Professional Modifier None Typical Low $138.04 Median $158.49 Typical High $257.04 | Professional | None | $138.04 | $158.49 | $257.04 |
Excellus BCBS Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $660.69 | Professional | None | $95.50 | $123.03 | $660.69 |
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 $199.53 Median $199.53 Typical High $354.81 | Professional | None | $199.53 | $199.53 | $354.81 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,332.54 | Facility | None | $1,230.27 | $3,162.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $354.81 | Professional | None | $104.71 | $162.18 | $354.81 |
Univera Setting Facility Modifier None Typical Low $112.20 Median $123.03 Typical High $501.19 | Facility | None | $112.20 | $123.03 | $501.19 |
Univera Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $645.65 | Professional | None | $95.50 | $123.03 | $645.65 |
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 $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $63.10 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $25.12 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $93.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $18.62 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.59 | $16.22 | $16.22 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $91.20 Typical High $131.83 | Professional | 53 · Discontinued | $66.07 | $91.20 | $131.83 |
Where New York sits
The same service costs 10.7 times more in Oklahoma 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
$132
OK $1,413NY $132
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.