How much rates vary
Facilitymedian $2,630 · 10th to 90th $186 to $5,129Professionalmedian $91 · 10th to 90th $48 to $126
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 $1,348.96 Median $4,265.80 Typical High $9,772.37 | Facility | None | $1,348.96 | $4,265.80 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $114.82 | Professional | None | $85.11 | $93.33 | $114.82 |
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 $85.11 Median $100.00 Typical High $109.65 | Professional | None | $85.11 | $100.00 | $109.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $147.91 Typical High $165.96 | Professional | 50 · Both sides | $125.89 | $147.91 | $165.96 |
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 $61.66 Median $61.66 Typical High $109.65 | Professional | None | $61.66 | $61.66 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $134.90 Typical High $1,479.11 | Facility | None | $69.18 | $134.90 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $70.79 Typical High $173.78 | Professional | None | $38.90 | $70.79 | $173.78 |
Emblem Health Setting Facility Modifier None Typical Low $45.71 Median $75.86 Typical High $158.49 | Facility | None | $45.71 | $75.86 | $158.49 |
Emblem Health Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $144.54 | Professional | None | $74.13 | $95.50 | $144.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $100.00 | Professional | None | $61.66 | $75.86 | $100.00 |
MVP Health Care Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
MVP Health Care Setting Professional Modifier None Typical Low $70.79 Median $123.03 Typical High $208.93 | Professional | None | $70.79 | $123.03 | $208.93 |
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 $36.31 Median $66.07 Typical High $134.90 | Professional | None | $36.31 | $66.07 | $134.90 |
Univera Setting Facility Modifier None Typical Low $40.74 Median $74.13 Typical High $354.81 | Facility | None | $40.74 | $74.13 | $354.81 |
Univera Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $100.00 | Professional | None | $61.66 | $75.86 | $100.00 |
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 $42.66 Median $46.77 Typical High $57.54 | Professional | 52 · Reduced service | $42.66 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $23.44 | Professional | 53 · Discontinued | $16.98 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $70.79 Typical High $87.10 | Professional | 54 · Surgery only | $63.10 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.13 Typical High $17.38 | Professional | 55 · Aftercare only | $12.59 | $14.13 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $11.48 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.02 Typical High $60.26 | Professional | 53 · Discontinued | $35.48 | $38.02 | $60.26 |
Where New York sits
The same service costs 3.0 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· 30th of 51
$93.33
AK $182VA $60.26
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.