How much rates vary
Facilitymedian $2,570 · 10th to 90th $115 to $5,012Professionalmedian $52 · 10th to 90th $40 to $112
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 $1,000.00 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,000.00 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $104.71 Typical High $114.82 | Professional | None | $56.23 | $104.71 | $114.82 |
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 $42.66 Median $50.12 Typical High $79.43 | Professional | None | $42.66 | $50.12 | $79.43 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $63.10 Median $75.86 Typical High $117.49 | Professional | 50 · Both sides | $63.10 | $75.86 | $117.49 |
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 $66.07 Median $66.07 Typical High $72.44 | Professional | None | $66.07 | $66.07 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $67.61 Typical High $1,479.11 | Facility | None | $35.48 | $67.61 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $41.69 Typical High $128.82 | Professional | None | $38.02 | $41.69 | $128.82 |
Emblem Health Setting Facility Modifier None Typical Low $38.02 Median $60.26 Typical High $154.88 | Facility | None | $38.02 | $60.26 | $154.88 |
Emblem Health Setting Professional Modifier None Typical Low $46.77 Median $61.66 Typical High $95.50 | Professional | None | $46.77 | $61.66 | $95.50 |
Excellus BCBS Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $66.07 | Professional | None | $41.69 | $45.71 | $66.07 |
Highmark BCBS Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $354.81 | Facility | None | $19.95 | $19.95 | $354.81 |
Highmark BCBS Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $69.18 | Professional | None | $64.57 | $64.57 | $69.18 |
MVP Health Care Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
MVP Health Care Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $93.33 | Professional | None | $60.26 | $60.26 | $93.33 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $35.48 Median $58.88 Typical High $97.72 | Professional | None | $35.48 | $58.88 | $97.72 |
Univera Setting Facility Modifier None Typical Low $44.67 Median $46.77 Typical High $218.78 | Facility | None | $44.67 | $46.77 | $218.78 |
Univera Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $66.07 | Professional | None | $41.69 | $45.71 | $66.07 |
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 $28.18 Median $52.48 Typical High $57.54 | Professional | 52 · Reduced service | $28.18 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $20.89 Typical High $22.91 | Professional | 53 · Discontinued | $11.22 | $20.89 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $79.43 Typical High $85.11 | Professional | 54 · Surgery only | $42.66 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $15.85 Typical High $16.98 | Professional | 55 · Aftercare only | $8.51 | $15.85 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $10.47 Typical High $11.48 | Professional | 56 · Pre-op care only | $5.62 | $10.47 | $11.48 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $38.90 Typical High $52.48 | Professional | 53 · Discontinued | $32.36 | $38.90 | $52.48 |
Where New York sits
The same service costs 3.6 times more in Wyoming than in Florida. 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· 50th of 51
$53.70
WY $191FL $52.48
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.