How much rates vary
Facilitymedian $316 · 10th to 90th $191 to $794Professionalmedian $234 · 10th to 90th $186 to $363
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 $204.17 Median $309.03 Typical High $691.83 | Facility | None | $204.17 | $309.03 | $691.83 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $371.54 | Professional | None | $204.17 | $204.17 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $302.00 Typical High $512.86 | Professional | None | $257.04 | $302.00 | $512.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $346.74 | Professional | None | $199.53 | $234.42 | $346.74 |
CDPHP Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $524.81 Typical High $524.81 | Facility | None | $275.42 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $446.68 | Professional | None | $213.80 | $251.19 | $446.68 |
Emblem Health Setting Facility Modifier None Typical Low $186.21 Median $331.13 Typical High $1,174.90 | Facility | None | $186.21 | $331.13 | $1,174.90 |
Emblem Health Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $616.60 | Professional | None | $257.04 | $363.08 | $616.60 |
Excellus BCBS Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $371.54 | Professional | None | $208.93 | $257.04 | $371.54 |
Highmark BCBS Setting Professional Modifier None Typical Low $275.42 Median $281.84 Typical High $478.63 | Professional | None | $275.42 | $281.84 | $478.63 |
MVP Health Care Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
MVP Health Care Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $331.13 | Professional | None | $177.83 | $177.83 | $331.13 |
United Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $354.81 | Professional | None | $204.17 | $245.47 | $354.81 |
Univera Setting Facility Modifier None Typical Low $245.47 Median $316.23 Typical High $912.01 | Facility | None | $245.47 | $316.23 | $912.01 |
Univera Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $331.13 | Professional | None | $208.93 | $257.04 | $331.13 |
5 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 $102.33 Median $102.33 Typical High $154.88 | Professional | 52 · Reduced service | $102.33 | $102.33 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $61.66 | Professional | 53 · Discontinued | $40.74 | $40.74 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $46.77 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $30.90 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $30.90 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $158.49 Typical High $251.19 | Professional | 53 · Discontinued | $125.89 | $158.49 | $251.19 |
Where New York sits
The same service costs 2.8 times more in Alaska than in New York. 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· 51st of 51
$234
AK $661NY $234
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.