How much rates vary
Facilitymedian $2,630 · 10th to 90th $229 to $5,012Professionalmedian $42 · 10th to 90th $31 to $60
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 $53.70 Median $3,981.07 Typical High $10,232.93 | Facility | None | $53.70 | $3,981.07 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $45.71 Typical High $56.23 | Professional | None | $38.90 | $45.71 | $56.23 |
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 $36.31 Median $42.66 Typical High $60.26 | Professional | None | $36.31 | $42.66 | $60.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $52.48 Median $63.10 Typical High $81.28 | Professional | 50 · Both sides | $52.48 | $63.10 | $81.28 |
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 $47.86 Median $47.86 Typical High $58.88 | Professional | None | $47.86 | $47.86 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $100.00 Typical High $1,096.48 | Facility | None | $51.29 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $33.11 Typical High $75.86 | Professional | None | $26.92 | $33.11 | $75.86 |
Emblem Health Setting Facility Modifier None Typical Low $33.11 Median $56.23 Typical High $120.23 | Facility | None | $33.11 | $56.23 | $120.23 |
Emblem Health Setting Professional Modifier None Typical Low $37.15 Median $48.98 Typical High $75.86 | Professional | None | $37.15 | $48.98 | $75.86 |
Excellus BCBS Setting Professional Modifier None Typical Low $22.39 Median $36.31 Typical High $54.95 | Professional | None | $22.39 | $36.31 | $54.95 |
Highmark BCBS Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Highmark BCBS Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
MVP Health Care Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
MVP Health Care Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $61.66 | Professional | None | $34.67 | $34.67 | $61.66 |
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 $25.70 Median $38.02 Typical High $60.26 | Professional | None | $25.70 | $38.02 | $60.26 |
Univera Setting Facility Modifier None Typical Low $32.36 Median $37.15 Typical High $117.49 | Facility | None | $32.36 | $37.15 | $117.49 |
Univera Setting Professional Modifier None Typical Low $22.39 Median $37.15 Typical High $54.95 | Professional | None | $22.39 | $37.15 | $54.95 |
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 $20.42 Median $22.91 Typical High $25.12 | Professional | 52 · Reduced service | $20.42 | $22.91 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $9.33 Typical High $10.00 | Professional | 53 · Discontinued | $8.13 | $9.33 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $34.67 Typical High $38.02 | Professional | 54 · Surgery only | $30.90 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.92 Typical High $7.59 | Professional | 55 · Aftercare only | $6.17 | $6.92 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.57 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.07 | $4.57 | $5.01 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $26.92 Typical High $36.31 | Professional | 53 · Discontinued | $20.89 | $26.92 | $36.31 |
Where New York sits
The same service costs 3.8 times more in Alaska than in Utah. 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
$41.69
AK $135UT $35.48
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.