How much rates vary
Facilitymedian $2,630 · 10th to 90th $100 to $5,012Professionalmedian $16 · 10th to 90th $12 to $30
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 $18.20 Median $3,162.28 Typical High $7,762.47 | Facility | None | $18.20 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $13.49 Typical High $37.15 | Professional | None | $12.02 | $13.49 | $37.15 |
Ambetter Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | None | $15.85 | $15.85 | $15.85 |
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 $13.49 Median $16.22 Typical High $27.54 | Professional | None | $13.49 | $16.22 | $27.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $19.50 Median $23.99 Typical High $39.81 | Professional | 50 · Both sides | $19.50 | $23.99 | $39.81 |
CDPHP Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $794.33 Typical High $1,778.28 | Facility | None | $100.00 | $794.33 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $11.75 Median $17.78 Typical High $58.88 | Professional | None | $11.75 | $17.78 | $58.88 |
Emblem Health Setting Facility Modifier None Typical Low $9.12 Median $20.42 Typical High $67.61 | Facility | None | $9.12 | $20.42 | $67.61 |
Emblem Health Setting Professional Modifier None Typical Low $20.42 Median $21.88 Typical High $35.48 | Professional | None | $20.42 | $21.88 | $35.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $10.47 Median $15.49 Typical High $20.42 | Professional | None | $10.47 | $15.49 | $20.42 |
Highmark BCBS Setting Facility Modifier None Typical Low $23.44 Median $46.77 Typical High $263.03 | Facility | None | $23.44 | $46.77 | $263.03 |
MVP Health Care Setting Professional Modifier None Typical Low $19.95 Median $22.91 Typical High $36.31 | Professional | None | $19.95 | $22.91 | $36.31 |
United Setting Facility Modifier None Typical Low $309.03 Median $1,148.15 Typical High $4,365.16 | Facility | None | $309.03 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $8.32 Median $15.14 Typical High $39.81 | Professional | None | $8.32 | $15.14 | $39.81 |
Univera Setting Facility Modifier None Typical Low $12.02 Median $16.60 Typical High $20.89 | Facility | None | $12.02 | $16.60 | $20.89 |
Univera Setting Professional Modifier None Typical Low $10.23 Median $15.49 Typical High $19.50 | Professional | None | $10.23 | $15.49 | $19.50 |
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 $6.03 Median $6.03 Typical High $9.12 | Professional | 52 · Reduced service | $6.03 | $6.03 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $3.63 | Professional | 53 · Discontinued | $2.40 | $2.40 | $3.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.91 Median $8.91 Typical High $13.49 | Professional | 54 · Surgery only | $8.91 | $8.91 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $1.78 Typical High $2.69 | Professional | 55 · Aftercare only | $1.78 | $1.78 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $1.82 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $9.55 Typical High $15.85 | Professional | 53 · Discontinued | $6.92 | $9.55 | $15.85 |
Where New York sits
The same service costs 7.4 times more in Kansas 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· 50th of 51
$16.98
KS $95.50KY $12.88
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.