How much rates vary
Facilitymedian $2,754 · 10th to 90th $525 to $5,248Professionalmedian $112 · 10th to 90th $91 to $251
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 $1,513.56 Median $4,570.88 Typical High $10,471.29 | Facility | None | $1,513.56 | $4,570.88 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $426.58 | Professional | None | $125.89 | $144.54 | $426.58 |
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 $93.33 Median $109.65 Typical High $218.78 | Professional | None | $93.33 | $109.65 | $218.78 |
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 $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $891.25 Typical High $1,584.89 | Facility | None | $478.63 | $891.25 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $660.69 | Professional | None | $107.15 | $151.36 | $660.69 |
Emblem Health Setting Facility Modifier None Typical Low $100.00 Median $141.25 Typical High $446.68 | Facility | None | $100.00 | $141.25 | $446.68 |
Emblem Health Setting Professional Modifier None Typical Low $128.82 Median $147.91 Typical High $239.88 | Professional | None | $128.82 | $147.91 | $239.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $144.54 | Professional | None | $85.11 | $102.33 | $144.54 |
MVP Health Care Setting Facility Modifier None Typical Low $112.20 Median $60,255.96 Typical High $87,096.36 | Facility | None | $112.20 | $60,255.96 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $309.03 | Professional | None | $162.18 | $162.18 | $309.03 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $4,897.79 | Facility | None | $549.54 | $1,737.80 | $4,897.79 |
United Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $363.08 | Professional | None | $97.72 | $151.36 | $363.08 |
Univera Setting Facility Modifier None Typical Low $100.00 Median $107.15 Typical High $537.03 | Facility | None | $100.00 | $107.15 | $537.03 |
Univera Setting Professional Modifier None Typical Low $85.11 Median $102.33 Typical High $144.54 | Professional | None | $85.11 | $102.33 | $144.54 |
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 $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $63.10 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $25.12 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $109.65 Typical High $109.65 | Professional | 54 · Surgery only | $95.50 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $19.05 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.59 | $14.45 | $14.45 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $75.86 Typical High $112.20 | Professional | 53 · Discontinued | $54.95 | $75.86 | $112.20 |
Where New York sits
The same service costs 4.4 times more in Alaska 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
$117
AK $513NY $117
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.