How much rates vary
Facilitymedian $2,692 · 10th to 90th $513 to $5,248Professionalmedian $129 · 10th to 90th $91 to $229
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 $1,318.26 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $162.18 Typical High $177.83 | Professional | None | $104.71 | $162.18 | $177.83 |
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 $109.65 Median $128.82 Typical High $158.49 | Professional | None | $109.65 | $128.82 | $158.49 |
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 $123.03 Median $123.03 Typical High $204.17 | Professional | None | $123.03 | $123.03 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,122.02 Typical High $1,819.70 | Facility | None | $645.65 | $1,122.02 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $117.49 Typical High $288.40 | Professional | None | $70.79 | $117.49 | $288.40 |
Emblem Health Setting Facility Modifier None Typical Low $75.86 Median $97.72 Typical High $331.13 | Facility | None | $75.86 | $97.72 | $331.13 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $1,819.70 | Professional | None | $162.18 | $199.53 | $1,819.70 |
Excellus BCBS Setting Professional Modifier None Typical Low $104.71 Median $141.25 Typical High $173.78 | Professional | None | $104.71 | $141.25 | $173.78 |
MVP Health Care Setting Facility Modifier None Typical Low $109.65 Median $3,235.94 Typical High $4,365.16 | Facility | None | $109.65 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $151.36 Median $229.09 Typical High $363.08 | Professional | None | $151.36 | $229.09 | $363.08 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,819.70 Typical High $4,897.79 | Facility | None | $549.54 | $1,819.70 | $4,897.79 |
United Setting Professional Modifier None Typical Low $67.61 Median $131.83 Typical High $251.19 | Professional | None | $67.61 | $131.83 | $251.19 |
Univera Setting Facility Modifier None Typical Low $77.62 Median $125.89 Typical High $199.53 | Facility | None | $77.62 | $125.89 | $199.53 |
Univera Setting Professional Modifier None Typical Low $104.71 Median $134.90 Typical High $173.78 | Professional | None | $104.71 | $134.90 | $173.78 |
5 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 $52.48 Median $79.43 Typical High $87.10 | Professional | 52 · Reduced service | $52.48 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $31.62 Typical High $35.48 | Professional | 53 · Discontinued | $20.89 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $117.49 Typical High $131.83 | Professional | 54 · Surgery only | $79.43 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $23.99 Typical High $26.30 | Professional | 55 · Aftercare only | $15.85 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.47 | $15.85 | $17.78 |
Where New York sits
The same service costs 7.8 times more in New York than in North Dakota. 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 $2,820ND $362
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.