How much rates vary
Facilitymedian $2,692 · 10th to 90th $200 to $5,248Professionalmedian $87 · 10th to 90th $59 to $166
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 $588.84 Median $3,981.07 Typical High $8,128.31 | Facility | None | $588.84 | $3,981.07 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $165.96 | Professional | None | $81.28 | $102.33 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $89.13 | Professional | None | $79.43 | $79.43 | $89.13 |
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 $77.62 Median $91.20 Typical High $123.03 | Professional | None | $77.62 | $91.20 | $123.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $138.04 Typical High $181.97 | Professional | 50 · Both sides | $117.49 | $138.04 | $181.97 |
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 $81.28 Median $81.28 Typical High $125.89 | Professional | None | $81.28 | $81.28 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $131.83 Typical High $1,479.11 | Facility | None | $69.18 | $131.83 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $186.21 | Professional | None | $46.77 | $75.86 | $186.21 |
Emblem Health Setting Facility Modifier None Typical Low $54.95 Median $79.43 Typical High $194.98 | Facility | None | $54.95 | $79.43 | $194.98 |
Emblem Health Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $177.83 | Professional | None | $85.11 | $107.15 | $177.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $123.03 | Professional | None | $66.07 | $87.10 | $123.03 |
Highmark BCBS Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $2,630.27 | Facility | None | $302.00 | $302.00 | $2,630.27 |
MVP Health Care Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
MVP Health Care Setting Professional Modifier None Typical Low $87.10 Median $109.65 Typical High $245.47 | Professional | None | $87.10 | $109.65 | $245.47 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $4,897.79 | Facility | None | $549.54 | $1,737.80 | $4,897.79 |
United Setting Professional Modifier None Typical Low $43.65 Median $81.28 Typical High $162.18 | Professional | None | $43.65 | $81.28 | $162.18 |
Univera Setting Facility Modifier None Typical Low $50.12 Median $85.11 Typical High $323.59 | Facility | None | $50.12 | $85.11 | $323.59 |
Univera Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $123.03 | Professional | None | $66.07 | $85.11 | $123.03 |
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 $43.65 Median $51.29 Typical High $83.18 | Professional | 52 · Reduced service | $43.65 | $51.29 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $20.42 Typical High $33.11 | Professional | 53 · Discontinued | $17.38 | $20.42 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $75.86 Typical High $125.89 | Professional | 54 · Surgery only | $66.07 | $75.86 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $15.14 Typical High $25.12 | Professional | 55 · Aftercare only | $13.18 | $15.14 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.23 Typical High $16.60 | Professional | 56 · Pre-op care only | $8.71 | $10.23 | $16.60 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $46.77 Typical High $70.79 | Professional | 53 · Discontinued | $43.65 | $46.77 | $70.79 |
Where New York sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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
$89.13
AK $224KY $69.18
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.