How much rates vary
Facilitymedian $2,692 · 10th to 90th $209 to $5,129Professionalmedian $112 · 10th to 90th $63 to $182
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 $128.82 Median $3,715.35 Typical High $8,128.31 | Facility | None | $128.82 | $3,715.35 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $154.88 | Professional | None | $100.00 | $128.82 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $100.00 Median $117.49 Typical High $147.91 | Professional | None | $100.00 | $117.49 | $147.91 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $165.96 Typical High $194.98 | Professional | 50 · Both sides | $100.00 | $165.96 | $194.98 |
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 $77.62 Median $77.62 Typical High $162.18 | Professional | None | $77.62 | $77.62 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $218.78 Typical High $1,479.11 | Facility | None | $114.82 | $218.78 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $95.50 Typical High $234.42 | Professional | None | $45.71 | $95.50 | $234.42 |
Emblem Health Setting Facility Modifier None Typical Low $57.54 Median $79.43 Typical High $204.17 | Facility | None | $57.54 | $79.43 | $204.17 |
Emblem Health Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $239.88 | Professional | None | $102.33 | $144.54 | $239.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $138.04 | Professional | None | $83.18 | $109.65 | $138.04 |
Highmark BCBS Setting Facility Modifier None Typical Low $64.57 Median $1,230.27 Typical High $1,445.44 | Facility | None | $64.57 | $1,230.27 | $1,445.44 |
MVP Health Care Setting Facility Modifier None Typical Low $93.33 Median $3,235.94 Typical High $4,365.16 | Facility | None | $93.33 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $302.00 | Professional | None | $112.20 | $112.20 | $302.00 |
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 $45.71 Median $95.50 Typical High $194.98 | Professional | None | $45.71 | $95.50 | $194.98 |
Univera Setting Facility Modifier None Typical Low $48.98 Median $102.33 Typical High $346.74 | Facility | None | $48.98 | $102.33 | $346.74 |
Univera Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $138.04 | Professional | None | $83.18 | $109.65 | $138.04 |
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 $53.70 Median $64.57 Typical High $75.86 | Professional | 52 · Reduced service | $53.70 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $25.70 Typical High $30.20 | Professional | 53 · Discontinued | $21.38 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $95.50 Typical High $112.20 | Professional | 54 · Surgery only | $79.43 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.50 Typical High $22.39 | Professional | 55 · Aftercare only | $15.85 | $19.50 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $12.88 Typical High $15.14 | Professional | 56 · Pre-op care only | $10.72 | $12.88 | $15.14 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $60.26 Typical High $91.20 | Professional | 53 · Discontinued | $57.54 | $60.26 | $91.20 |
Where New York sits
The same service costs 3.2 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
$112
AK $263VA $81.28
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.