How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,148 to $23,442Professionalmedian $676 · 10th to 90th $537 to $1,318
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 $1,621.81 Median $6,165.95 Typical High $14,454.40 | Facility | None | $1,621.81 | $6,165.95 | $14,454.40 |
Aetna Setting Professional Modifier None (both parts) Typical Low $691.83 Median $691.83 Typical High $3,090.30 | Professional | None (both parts) | $691.83 | $691.83 | $3,090.30 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $213.80 Median $213.80 Typical High $416.87 | Professional | 26 · Professional part | $213.80 | $213.80 | $416.87 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $478.63 Median $478.63 Typical High $851.14 | Professional | TC · Technical part | $478.63 | $478.63 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $9,772.37 Typical High $28,183.83 | Facility | None | $1,513.56 | $9,772.37 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $549.54 Median $660.69 Typical High $1,230.27 | Professional | None (both parts) | $549.54 | $660.69 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $173.78 Median $208.93 Typical High $398.11 | Professional | 26 · Professional part | $173.78 | $208.93 | $398.11 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $380.19 Median $457.09 Typical High $831.76 | Professional | TC · Technical part | $380.19 | $457.09 | $831.76 |
CDPHP Setting Facility Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $15,135.61 | Facility | None | $5,011.87 | $5,011.87 | $15,135.61 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $316.23 Median $676.08 Typical High $1,000.00 | Professional | None (both parts) | $316.23 | $676.08 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $13,803.84 Typical High $21,877.62 | Facility | None | $1,862.09 | $13,803.84 | $21,877.62 |
Cigna Setting Professional Modifier None (both parts) Typical Low $707.95 Median $812.83 Typical High $2,187.76 | Professional | None (both parts) | $707.95 | $812.83 | $2,187.76 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $234.42 Median $251.19 Typical High $724.44 | Professional | 26 · Professional part | $234.42 | $251.19 | $724.44 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $467.74 Median $562.34 Typical High $1,584.89 | Professional | TC · Technical part | $467.74 | $562.34 | $1,584.89 |
Emblem Health Setting Facility Modifier None Typical Low $363.08 Median $562.34 Typical High $2,290.87 | Facility | None | $363.08 | $562.34 | $2,290.87 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $691.83 Median $794.33 Typical High $1,412.54 | Professional | None (both parts) | $691.83 | $794.33 | $1,412.54 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $416.87 Median $616.60 Typical High $1,000.00 | Professional | None (both parts) | $416.87 | $616.60 | $1,000.00 |
Excellus BCBS Setting Professional Modifier 26 · Professional part Typical Low $147.91 Median $208.93 Typical High $363.08 | Professional | 26 · Professional part | $147.91 | $208.93 | $363.08 |
Excellus BCBS Setting Professional Modifier TC · Technical part Typical Low $263.03 Median $407.38 Typical High $645.65 | Professional | TC · Technical part | $263.03 | $407.38 | $645.65 |
Highmark BCBS Setting Facility Modifier None Typical Low $10,471.29 Median $10,471.29 Typical High $10,715.19 | Facility | None | $10,471.29 | $10,471.29 | $10,715.19 |
MVP Health Care Setting Facility Modifier None Typical Low $5,754.40 Median $12,882.50 Typical High $17,378.01 | Facility | None | $5,754.40 | $12,882.50 | $17,378.01 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $398.11 Median $398.11 Typical High $1,621.81 | Professional | None (both parts) | $398.11 | $398.11 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,090.30 Typical High $11,481.54 | Facility | None | $1,230.27 | $3,090.30 | $11,481.54 |
United Setting Professional Modifier None (both parts) Typical Low $524.81 Median $812.83 Typical High $1,778.28 | Professional | None (both parts) | $524.81 | $812.83 | $1,778.28 |
United Setting Professional Modifier 26 · Professional part Typical Low $177.83 Median $275.42 Typical High $588.84 | Professional | 26 · Professional part | $177.83 | $275.42 | $588.84 |
United Setting Professional Modifier TC · Technical part Typical Low $354.81 Median $562.34 Typical High $1,230.27 | Professional | TC · Technical part | $354.81 | $562.34 | $1,230.27 |
Univera Setting Facility Modifier None Typical Low $416.87 Median $616.60 Typical High $2,137.96 | Facility | None | $416.87 | $616.60 | $2,137.96 |
Univera Setting Facility Modifier 26 · Professional part Typical Low $147.91 Median $181.97 Typical High $1,096.48 | Facility | 26 · Professional part | $147.91 | $181.97 | $1,096.48 |
Univera Setting Facility Modifier TC · Technical part Typical Low $263.03 Median $426.58 Typical High $660.69 | Facility | TC · Technical part | $263.03 | $426.58 | $660.69 |
Univera Setting Professional Modifier None (both parts) Typical Low $416.87 Median $616.60 Typical High $1,000.00 | Professional | None (both parts) | $416.87 | $616.60 | $1,000.00 |
Univera Setting Professional Modifier 26 · Professional part Typical Low $147.91 Median $208.93 Typical High $363.08 | Professional | 26 · Professional part | $147.91 | $208.93 | $363.08 |
Univera Setting Professional Modifier TC · Technical part Typical Low $263.03 Median $407.38 Typical High $645.65 | Professional | TC · Technical part | $263.03 | $407.38 | $645.65 |
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 $346.74 Median $346.74 Typical High $416.87 | Professional | 52 · Reduced service | $346.74 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | 53 · Discontinued | $138.04 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | 54 · Surgery only | $512.86 | $512.86 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $83.18 |
Where New York sits
The same service costs 4.4 times more in Wisconsin than in Texas. 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· 43rd of 51
$708
WI $2,630TX $603
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.