How much rates vary
Facilitymedian $2,692 · 10th to 90th $251 to $5,012Professionalmedian $79 · 10th to 90th $48 to $178
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 $181.97 Median $3,981.07 Typical High $10,232.93 | Facility | None | $181.97 | $3,981.07 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $93.33 Typical High $147.91 | Professional | None | $47.86 | $93.33 | $147.91 |
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 $67.61 Median $81.28 Typical High $154.88 | Professional | None | $67.61 | $81.28 | $154.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $123.03 Typical High $229.09 | Professional | 50 · Both sides | $104.71 | $123.03 | $229.09 |
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 $72.44 Median $72.44 Typical High $112.20 | Professional | None | $72.44 | $72.44 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $100.00 Typical High $1,096.48 | Facility | None | $77.62 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $72.44 Typical High $331.13 | Professional | None | $38.90 | $72.44 | $331.13 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $54.95 Typical High $173.78 | Facility | None | $34.67 | $54.95 | $173.78 |
Emblem Health Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $158.49 | Professional | None | $85.11 | $97.72 | $158.49 |
Excellus BCBS Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $104.71 | Professional | None | $53.70 | $77.62 | $104.71 |
Highmark BCBS Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
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 $208.93 | Professional | None | $60.26 | $60.26 | $208.93 |
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 $31.62 Median $64.57 Typical High $199.53 | Professional | None | $31.62 | $64.57 | $199.53 |
Univera Setting Facility Modifier None Typical Low $40.74 Median $79.43 Typical High $186.21 | Facility | None | $40.74 | $79.43 | $186.21 |
Univera Setting Professional Modifier None Typical Low $53.70 Median $77.62 Typical High $104.71 | Professional | None | $53.70 | $77.62 | $104.71 |
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 $23.99 Median $46.77 Typical High $51.29 | Professional | 52 · Reduced service | $23.99 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $18.62 Typical High $20.42 | Professional | 53 · Discontinued | $9.55 | $18.62 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $69.18 Typical High $77.62 | Professional | 54 · Surgery only | $36.31 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $13.80 Typical High $15.49 | Professional | 55 · Aftercare only | $7.24 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $9.33 Typical High $10.23 | Professional | 56 · Pre-op care only | $4.79 | $9.33 | $10.23 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $52.48 Typical High $85.11 | Professional | 53 · Discontinued | $39.81 | $52.48 | $85.11 |
Where New York sits
The same service costs 3.2 times more in Wisconsin 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· 46th of 51
$81.28
WI $229KY $72.44
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.