How much rates vary
Facilitymedian $2,630 · 10th to 90th $200 to $4,898Professionalmedian $60 · 10th to 90th $42 to $87
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 $61.66 Median $3,715.35 Typical High $9,332.54 | Facility | None | $61.66 | $3,715.35 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $60.26 Typical High $81.28 | Professional | None | $48.98 | $60.26 | $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 $53.70 Median $63.10 Typical High $87.10 | Professional | None | $53.70 | $63.10 | $87.10 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $79.43 Median $93.33 Typical High $123.03 | Professional | 50 · Both sides | $79.43 | $93.33 | $123.03 |
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 $58.88 Median $58.88 Typical High $85.11 | Professional | None | $58.88 | $58.88 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $1,096.48 | Facility | None | $66.07 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $50.12 Typical High $100.00 | Professional | None | $33.88 | $50.12 | $100.00 |
Emblem Health Setting Facility Modifier None Typical Low $43.65 Median $100.00 Typical High $169.82 | Facility | None | $43.65 | $100.00 | $169.82 |
Emblem Health Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $117.49 | Professional | None | $53.70 | $75.86 | $117.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $30.90 Median $52.48 Typical High $79.43 | Professional | None | $30.90 | $52.48 | $79.43 |
Highmark BCBS Setting Facility Modifier None Typical Low $102.33 Median $426.58 Typical High $870.96 | Facility | None | $102.33 | $426.58 | $870.96 |
Highmark BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $74.13 | Professional | None | $70.79 | $70.79 | $74.13 |
MVP Health Care Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
MVP Health Care Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $89.13 | Professional | None | $61.66 | $61.66 | $89.13 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,258.93 Typical High $4,365.16 | Facility | None | $363.08 | $1,258.93 | $4,365.16 |
United Setting Professional Modifier None Typical Low $34.67 Median $51.29 Typical High $81.28 | Professional | None | $34.67 | $51.29 | $81.28 |
Univera Setting Facility Modifier None Typical Low $38.90 Median $53.70 Typical High $158.49 | Facility | None | $38.90 | $53.70 | $158.49 |
Univera Setting Professional Modifier None Typical Low $30.90 Median $53.70 Typical High $79.43 | Professional | None | $30.90 | $53.70 | $79.43 |
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 $24.55 Median $28.18 Typical High $36.31 | Professional | 52 · Reduced service | $24.55 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $11.22 Typical High $14.45 | Professional | 53 · Discontinued | $9.77 | $11.22 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $41.69 Typical High $54.95 | Professional | 54 · Surgery only | $37.15 | $41.69 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.32 Typical High $10.96 | Professional | 55 · Aftercare only | $7.41 | $8.32 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.62 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.90 | $5.62 | $7.24 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $37.15 Typical High $52.48 | Professional | 53 · Discontinued | $30.20 | $37.15 | $52.48 |
Where New York sits
The same service costs 3.8 times more in Alaska than in Maryland. 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· 38th of 51
$61.66
AK $191MD $50.12
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.