How much rates vary
Facilitymedian $3,467 · 10th to 90th $724 to $6,457Professionalmedian $234 · 10th to 90th $141 to $407
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 $616.60 Median $4,168.69 Typical High $8,128.31 | Facility | None | $616.60 | $4,168.69 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $275.42 Typical High $309.03 | Professional | None | $138.04 | $275.42 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $3,548.13 Typical High $4,897.79 | Facility | None | $1,819.70 | $3,548.13 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $338.84 | Professional | None | $199.53 | $234.42 | $338.84 |
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 $169.82 Median $169.82 Typical High $380.19 | Professional | None | $169.82 | $169.82 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $229.09 Typical High $549.54 | Professional | None | $97.72 | $229.09 | $549.54 |
Emblem Health Setting Facility Modifier None Typical Low $117.49 Median $151.36 Typical High $389.05 | Facility | None | $117.49 | $151.36 | $389.05 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $436.52 | Professional | None | $263.03 | $295.12 | $436.52 |
Excellus BCBS Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $323.59 | Professional | None | $190.55 | $245.47 | $323.59 |
MVP Health Care Setting Facility Modifier None Typical Low $151.36 Median $3,235.94 Typical High $4,365.16 | Facility | None | $151.36 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $645.65 | Professional | None | $302.00 | $302.00 | $645.65 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $3,311.31 Typical High $6,165.95 | Facility | None | $1,513.56 | $3,311.31 | $6,165.95 |
United Setting Professional Modifier None Typical Low $109.65 Median $229.09 Typical High $478.63 | Professional | None | $109.65 | $229.09 | $478.63 |
Univera Setting Facility Modifier None Typical Low $107.15 Median $138.04 Typical High $371.54 | Facility | None | $107.15 | $138.04 | $371.54 |
Univera Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $323.59 | Professional | None | $190.55 | $239.88 | $323.59 |
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 $69.18 Median $125.89 Typical High $154.88 | Professional | 52 · Reduced service | $69.18 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $50.12 Typical High $61.66 | Professional | 53 · Discontinued | $28.18 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $190.55 Typical High $229.09 | Professional | 54 · Surgery only | $104.71 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $38.02 Typical High $45.71 | Professional | 55 · Aftercare only | $20.89 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $25.12 Typical High $30.90 | Professional | 56 · Pre-op care only | $13.80 | $25.12 | $30.90 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $169.82 Typical High $245.47 | Professional | 53 · Discontinued | $138.04 | $169.82 | $245.47 |
Where New York sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 37th of 51
$234
AK $525VA $155
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.