How much rates vary
Facilitymedian $2,754 · 10th to 90th $525 to $5,248Professionalmedian $98 · 10th to 90th $78 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 $120.23 Median $120.23 Typical High $380.19 | Professional | None | $120.23 | $120.23 | $380.19 |
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 $77.62 Median $91.20 Typical High $208.93 | Professional | None | $77.62 | $91.20 | $208.93 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $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 $95.50 Median $141.25 Typical High $630.96 | Professional | None | $95.50 | $141.25 | $630.96 |
Emblem Health Setting Facility Modifier None Typical Low $128.82 Median $251.19 Typical High $489.78 | Facility | None | $128.82 | $251.19 | $489.78 |
Emblem Health Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $223.87 | Professional | None | $117.49 | $134.90 | $223.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $144.54 | Professional | None | $83.18 | $97.72 | $144.54 |
MVP Health Care Setting Facility Modifier None Typical Low $134.90 Median $60,255.96 Typical High $87,096.36 | Facility | None | $134.90 | $60,255.96 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $181.97 Median $194.98 Typical High $363.08 | Professional | None | $181.97 | $194.98 | $363.08 |
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 $89.13 Median $141.25 Typical High $363.08 | Professional | None | $89.13 | $141.25 | $363.08 |
Univera Setting Facility Modifier None Typical Low $97.72 Median $100.00 Typical High $933.25 | Facility | None | $97.72 | $100.00 | $933.25 |
Univera Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $144.54 | Professional | None | $83.18 | $97.72 | $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 $60.26 Median $60.26 Typical High $67.61 | Professional | 52 · Reduced service | $60.26 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $26.92 | Professional | 53 · Discontinued | $23.99 | $23.99 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | 54 · Surgery only | $91.20 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $20.42 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $13.49 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $13.49 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $72.44 Typical High $109.65 | Professional | 53 · Discontinued | $53.70 | $72.44 | $109.65 |
Where New York sits
The same service costs 8.1 times more in New York than in Montana. 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.
Physician feeFacility fee
NY $2,852MT $352
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.