How much rates vary
Facilitymedian $2,399 · 10th to 90th $91 to $5,129Professionalmedian $76 · 10th to 90th $45 to $123
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 $52.48 Median $2,570.40 Typical High $7,762.47 | Facility | None | $52.48 | $2,570.40 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $87.10 Typical High $107.15 | Professional | None | $52.48 | $87.10 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $38.02 Median $72.44 Typical High $81.28 | Professional | None | $38.02 | $72.44 | $81.28 |
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 $67.61 Median $79.43 Typical High $100.00 | Professional | None | $67.61 | $79.43 | $100.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $120.23 Typical High $144.54 | Professional | 50 · Both sides | $102.33 | $120.23 | $144.54 |
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 $60.26 Median $60.26 Typical High $109.65 | Professional | None | $60.26 | $60.26 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $141.25 Typical High $1,479.11 | Facility | None | $72.44 | $141.25 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $64.57 Typical High $158.49 | Professional | None | $35.48 | $64.57 | $158.49 |
Emblem Health Setting Facility Modifier None Typical Low $44.67 Median $75.86 Typical High $158.49 | Facility | None | $44.67 | $75.86 | $158.49 |
Emblem Health Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $724.44 | Professional | None | $87.10 | $104.71 | $724.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $95.50 | Professional | None | $56.23 | $75.86 | $95.50 |
Highmark BCBS Setting Facility Modifier None Typical Low $50.12 Median $389.05 Typical High $1,445.44 | Facility | None | $50.12 | $389.05 | $1,445.44 |
Highmark BCBS Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $181.97 | Professional | None | $69.18 | $112.20 | $181.97 |
MVP Health Care Setting Facility Modifier None Typical Low $74.13 Median $25,118.86 Typical High $36,307.81 | Facility | None | $74.13 | $25,118.86 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $223.87 | Professional | None | $39.81 | $39.81 | $223.87 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,737.80 Typical High $4,897.79 | Facility | None | $537.03 | $1,737.80 | $4,897.79 |
United Setting Professional Modifier None Typical Low $35.48 Median $67.61 Typical High $131.83 | Professional | None | $35.48 | $67.61 | $131.83 |
Univera Setting Facility Modifier None Typical Low $37.15 Median $69.18 Typical High $302.00 | Facility | None | $37.15 | $69.18 | $302.00 |
Univera Setting Professional Modifier None Typical Low $56.23 Median $74.13 Typical High $95.50 | Professional | None | $56.23 | $74.13 | $95.50 |
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 $26.30 Median $42.66 Typical High $45.71 | Professional | 52 · Reduced service | $26.30 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $16.98 Typical High $18.20 | Professional | 53 · Discontinued | $10.47 | $16.98 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $64.57 Typical High $69.18 | Professional | 54 · Surgery only | $38.90 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $12.88 Typical High $13.80 | Professional | 55 · Aftercare only | $7.76 | $12.88 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $8.51 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.25 | $8.51 | $9.12 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $41.69 Typical High $61.66 | Professional | 53 · Discontinued | $38.90 | $41.69 | $61.66 |
Where New York sits
The same service costs 3.5 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· 35th of 51
$77.62
AK $204VA $58.88
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.