How much rates vary
Facilitymedian $2,692 · 10th to 90th $331 to $5,248Professionalmedian $186 · 10th to 90th $120 to $295
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 $645.65 Median $4,168.69 Typical High $9,332.54 | Facility | None | $645.65 | $4,168.69 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $229.09 | Professional | None | $141.25 | $190.55 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $181.97 Typical High $190.55 | Professional | None | $102.33 | $181.97 | $190.55 |
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 $165.96 Median $194.98 Typical High $218.78 | Professional | None | $165.96 | $194.98 | $218.78 |
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 $165.96 Median $165.96 Typical High $245.47 | Professional | None | $165.96 | $165.96 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $251.19 Typical High $489.78 | Facility | None | $128.82 | $251.19 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $158.49 Typical High $389.05 | Professional | None | $104.71 | $158.49 | $389.05 |
Emblem Health Setting Facility Modifier None Typical Low $112.20 Median $141.25 Typical High $426.58 | Facility | None | $112.20 | $141.25 | $426.58 |
Emblem Health Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $346.74 | Professional | None | $165.96 | $229.09 | $346.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $223.87 | Professional | None | $134.90 | $177.83 | $223.87 |
Highmark BCBS Setting Facility Modifier None Typical Low $891.25 Median $912.01 Typical High $912.01 | Facility | None | $891.25 | $912.01 | $912.01 |
MVP Health Care Setting Facility Modifier None Typical Low $138.04 Median $4,365.16 Typical High $36,307.81 | Facility | None | $138.04 | $4,365.16 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $380.19 | Professional | None | $95.50 | $95.50 | $380.19 |
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 $89.13 Median $173.78 Typical High $338.84 | Professional | None | $89.13 | $173.78 | $338.84 |
Univera Setting Facility Modifier None Typical Low $104.71 Median $165.96 Typical High $288.40 | Facility | None | $104.71 | $165.96 | $288.40 |
Univera Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $204.17 | Professional | None | $134.90 | $165.96 | $204.17 |
5 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 $70.79 Median $89.13 Typical High $95.50 | Professional | 52 · Reduced service | $70.79 | $89.13 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $35.48 Typical High $38.02 | Professional | 53 · Discontinued | $28.18 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $131.83 Typical High $144.54 | Professional | 54 · Surgery only | $107.15 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $26.92 Typical High $28.84 | Professional | 55 · Aftercare only | $21.38 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $17.78 Typical High $19.05 | Professional | 56 · Pre-op care only | $14.13 | $17.78 | $19.05 |
Where New York sits
The same service costs 3.3 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
$186
AK $468VA $141
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.