How much rates vary
Facilitymedian $245 · 10th to 90th $240 to $427Professionalmedian $245 · 10th to 90th $240 to $427
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 $245.47 Median $245.47 Typical High $537.03 | Facility | None | $245.47 | $245.47 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $251.19 | Facility | None | $239.88 | $239.88 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
CDPHP Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $354.81 Typical High $446.68 | Facility | None | $269.15 | $354.81 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $1,023.29 | Professional | None | $398.11 | $398.11 | $1,023.29 |
Emblem Health Setting Facility Modifier None Typical Low $229.09 Median $380.19 Typical High $831.76 | Facility | None | $229.09 | $380.19 | $831.76 |
Emblem Health Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $588.84 | Professional | None | $229.09 | $407.38 | $588.84 |
Excellus BCBS Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $251.19 | Facility | None | $239.88 | $239.88 | $251.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $251.19 | Professional | None | $239.88 | $239.88 | $251.19 |
Highmark BCBS Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
MVP Health Care Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $776.25 | Facility | None | $302.00 | $302.00 | $776.25 |
MVP Health Care Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $371.54 | Professional | None | $251.19 | $338.84 | $371.54 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $426.58 | Professional | None | $239.88 | $288.40 | $426.58 |
Univera Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $257.04 | Facility | None | $239.88 | $239.88 | $257.04 |
Univera Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $251.19 | Professional | None | $239.88 | $239.88 | $251.19 |
4 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 $120.23 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $24.55 |
Where New York sits
The same service costs 8.7 times more in Alabama than in Rhode Island. 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· 47th of 51
$245
AL $2,089RI $240
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.