How much rates vary
Facilitymedian $2,570 · 10th to 90th $166 to $4,898Professionalmedian $91 · 10th to 90th $45 to $186
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 $218.78 Median $3,981.07 Typical High $10,232.93 | Facility | None | $218.78 | $3,981.07 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $91.20 Typical High $154.88 | Professional | None | $45.71 | $91.20 | $154.88 |
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 $87.10 Median $102.33 Typical High $177.83 | Professional | None | $87.10 | $102.33 | $177.83 |
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 $141.25 | Professional | None | $66.07 | $66.07 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $165.96 Typical High $1,479.11 | Facility | None | $85.11 | $165.96 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $34.67 Median $74.13 Typical High $331.13 | Professional | None | $34.67 | $74.13 | $331.13 |
Emblem Health Setting Facility Modifier None Typical Low $39.81 Median $47.86 Typical High $154.88 | Facility | None | $39.81 | $47.86 | $154.88 |
Emblem Health Setting Professional Modifier None Typical Low $12.30 Median $83.18 Typical High $97.72 | Professional | None | $12.30 | $83.18 | $97.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $117.49 | Professional | None | $63.10 | $89.13 | $117.49 |
Highmark BCBS Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $794.33 | Facility | None | $575.44 | $575.44 | $794.33 |
MVP Health Care Setting Facility Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
MVP Health Care Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $245.47 | Professional | None | $44.67 | $44.67 | $245.47 |
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 $27.54 Median $69.18 Typical High $223.87 | Professional | None | $27.54 | $69.18 | $223.87 |
Univera Setting Facility Modifier None Typical Low $36.31 Median $87.10 Typical High $194.98 | Facility | None | $36.31 | $87.10 | $194.98 |
Univera Setting Professional Modifier None Typical Low $63.10 Median $87.10 Typical High $109.65 | Professional | None | $63.10 | $87.10 | $109.65 |
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 $22.39 Median $45.71 Typical High $58.88 | Professional | 52 · Reduced service | $22.39 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $18.62 Typical High $23.44 | Professional | 53 · Discontinued | $9.12 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $69.18 Typical High $87.10 | Professional | 54 · Surgery only | $33.88 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $13.80 Typical High $17.38 | Professional | 55 · Aftercare only | $6.76 | $13.80 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $9.12 Typical High $11.75 | Professional | 56 · Pre-op care only | $4.47 | $9.12 | $11.75 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $64.57 Typical High $95.50 | Professional | 53 · Discontinued | $48.98 | $64.57 | $95.50 |
Where New York sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 33rd of 51
$95.50
AK $204KY $61.66
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.