How much rates vary
Facilitymedian $3,162 · 10th to 90th $447 to $7,413Professionalmedian $162 · 10th to 90th $135 to $309
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 $1,819.70 Median $5,248.07 Typical High $10,471.29 | Facility | None | $1,819.70 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $204.17 | Professional | None | $162.18 | $162.18 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $234.42 | Professional | None | $134.90 | $158.49 | $234.42 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $1,479.11 Typical High $1,862.09 | Facility | None | $588.84 | $1,479.11 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $416.87 | Professional | None | $162.18 | $162.18 | $416.87 |
Emblem Health Setting Facility Modifier None Typical Low $186.21 Median $229.09 Typical High $645.65 | Facility | None | $186.21 | $229.09 | $645.65 |
Emblem Health Setting Professional Modifier None Typical Low $165.96 Median $181.97 Typical High $302.00 | Professional | None | $165.96 | $181.97 | $302.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $229.09 | Professional | None | $125.89 | $151.36 | $229.09 |
MVP Health Care Setting Facility Modifier None Typical Low $194.98 Median $4,365.16 Typical High $36,307.81 | Facility | None | $194.98 | $4,365.16 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $467.74 | Professional | None | $190.55 | $275.42 | $467.74 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $107.15 Median $199.53 Typical High $501.19 | Professional | None | $107.15 | $199.53 | $501.19 |
Univera Setting Facility Modifier None Typical Low $158.49 Median $165.96 Typical High $524.81 | Facility | None | $158.49 | $165.96 | $524.81 |
Univera Setting Professional Modifier None Typical Low $125.89 Median $151.36 Typical High $229.09 | Professional | None | $125.89 | $151.36 | $229.09 |
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 $81.28 Median $81.28 Typical High $102.33 | Professional | 52 · Reduced service | $81.28 | $81.28 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $40.74 | Professional | 53 · Discontinued | $32.36 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $120.23 Typical High $154.88 | Professional | 54 · Surgery only | $120.23 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $30.90 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $16.22 Typical High $20.42 | Professional | 56 · Pre-op care only | $16.22 | $16.22 | $20.42 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $102.33 Typical High $151.36 | Professional | 53 · Discontinued | $95.50 | $102.33 | $151.36 |
Where New York sits
The same service costs 4.5 times more in Alaska than in New York. 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· 51st of 51
$162
AK $724NY $162
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.