How much rates vary
Facilitymedian $3,236 · 10th to 90th $589 to $7,762Professionalmedian $126 · 10th to 90th $102 to $275
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 $1,819.70 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $288.40 | Professional | None | $141.25 | $162.18 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,585.78 | Facility | None | $1,288.25 | $3,890.45 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $245.47 | Professional | None | $104.71 | $123.03 | $245.47 |
CDPHP Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,737.80 Typical High $2,754.23 | Facility | None | $676.08 | $1,737.80 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $691.83 | Professional | None | $120.23 | $151.36 | $691.83 |
Emblem Health Setting Facility Modifier None Typical Low $138.04 Median $269.15 Typical High $562.34 | Facility | None | $138.04 | $269.15 | $562.34 |
Emblem Health Setting Professional Modifier None Typical Low $134.90 Median $154.88 Typical High $257.04 | Professional | None | $134.90 | $154.88 | $257.04 |
Excellus BCBS Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $158.49 | Professional | None | $89.13 | $107.15 | $158.49 |
MVP Health Care Setting Facility Modifier None Typical Low $128.82 Median $4,365.16 Typical High $87,096.36 | Facility | None | $128.82 | $4,365.16 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $338.84 | Professional | None | $158.49 | $158.49 | $338.84 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $102.33 Median $165.96 Typical High $407.38 | Professional | None | $102.33 | $165.96 | $407.38 |
Univera Setting Facility Modifier None Typical Low $109.65 Median $120.23 Typical High $426.58 | Facility | None | $109.65 | $120.23 | $426.58 |
Univera Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $154.88 | Professional | None | $89.13 | $107.15 | $154.88 |
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 $70.79 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $70.79 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $33.11 Typical High $33.11 | Professional | 53 · Discontinued | $28.18 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $123.03 Typical High $123.03 | Professional | 54 · Surgery only | $104.71 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $20.89 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $14.13 | $16.22 | $16.22 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $87.10 Typical High $134.90 | Professional | 53 · Discontinued | $63.10 | $87.10 | $134.90 |
Where New York sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 50th of 51
$132
AK $513UT $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.