How much rates vary
Facilitymedian $2,692 · 10th to 90th $102 to $5,370Professionalmedian $37 · 10th to 90th $23 to $56
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 $5,248.07 Typical High $10,471.29 | Facility | None | $1,513.56 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $36.31 Typical High $47.86 | Professional | None | $28.84 | $36.31 | $47.86 |
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 $31.62 Median $38.90 Typical High $43.65 | Professional | None | $31.62 | $38.90 | $43.65 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $44.67 | Professional | None | $34.67 | $34.67 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $41.69 Typical High $1,737.80 | Facility | None | $22.39 | $41.69 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $27.54 Typical High $67.61 | Professional | None | $21.88 | $27.54 | $67.61 |
Emblem Health Setting Facility Modifier None Typical Low $24.55 Median $75.86 Typical High $134.90 | Facility | None | $24.55 | $75.86 | $134.90 |
Emblem Health Setting Professional Modifier None Typical Low $28.84 Median $39.81 Typical High $60.26 | Professional | None | $28.84 | $39.81 | $60.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $24.55 Median $31.62 Typical High $40.74 | Professional | None | $24.55 | $31.62 | $40.74 |
MVP Health Care Setting Facility Modifier None Typical Low $53.70 Median $257.04 Typical High $38,018.94 | Facility | None | $53.70 | $257.04 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $79.43 | Professional | None | $28.18 | $28.18 | $79.43 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $18.20 Median $33.11 Typical High $67.61 | Professional | None | $18.20 | $33.11 | $67.61 |
Univera Setting Facility Modifier None Typical Low $21.88 Median $28.84 Typical High $114.82 | Facility | None | $21.88 | $28.84 | $114.82 |
Univera Setting Professional Modifier None Typical Low $24.55 Median $31.62 Typical High $38.90 | Professional | None | $24.55 | $31.62 | $38.90 |
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 $14.45 Median $18.20 Typical High $23.99 | Professional | 52 · Reduced service | $14.45 | $18.20 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $7.24 Typical High $9.55 | Professional | 53 · Discontinued | $5.75 | $7.24 | $9.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.88 Median $27.54 Typical High $35.48 | Professional | 54 · Surgery only | $21.88 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $5.50 Typical High $7.08 | Professional | 55 · Aftercare only | $4.37 | $5.50 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.63 Typical High $4.79 | Professional | 56 · Pre-op care only | $2.88 | $3.63 | $4.79 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $17.78 Typical High $26.30 | Professional | 53 · Discontinued | $16.60 | $17.78 | $26.30 |
Where New York sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 33rd of 51
$37.15
AK $100MD $28.84
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.