How much rates vary
Facilitymedian $2,754 · 10th to 90th $525 to $5,248Professionalmedian $105 · 10th to 90th $89 to $240
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 $97.72 Median $97.72 Typical High $407.38 | Professional | None | $97.72 | $97.72 | $407.38 |
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 $89.13 Median $104.71 Typical High $208.93 | Professional | None | $89.13 | $104.71 | $208.93 |
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 $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
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 $102.33 Median $134.90 Typical High $630.96 | Professional | None | $102.33 | $134.90 | $630.96 |
Emblem Health Setting Facility Modifier None Typical Low $100.00 Median $131.83 Typical High $426.58 | Facility | None | $100.00 | $131.83 | $426.58 |
Emblem Health Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $229.09 | Professional | None | $123.03 | $141.25 | $229.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $138.04 | Professional | None | $81.28 | $97.72 | $138.04 |
MVP Health Care Setting Facility Modifier None Typical Low $109.65 Median $60,255.96 Typical High $87,096.36 | Facility | None | $109.65 | $60,255.96 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $316.23 | Professional | None | $144.54 | $144.54 | $316.23 |
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 $93.33 Median $144.54 Typical High $354.81 | Professional | None | $93.33 | $144.54 | $354.81 |
Univera Setting Facility Modifier None Typical Low $95.50 Median $102.33 Typical High $407.38 | Facility | None | $95.50 | $102.33 | $407.38 |
Univera Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $134.90 | Professional | None | $81.28 | $97.72 | $134.90 |
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 $48.98 Median $48.98 Typical High $60.26 | Professional | 52 · Reduced service | $48.98 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $23.99 | Professional | 53 · Discontinued | $19.50 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | 54 · Surgery only | $74.13 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $17.78 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $12.02 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $12.02 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $72.44 Typical High $107.15 | Professional | 53 · Discontinued | $52.48 | $72.44 | $107.15 |
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
$110
AK $479NY $110
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.