How much rates vary
Facilitymedian $2,570 · 10th to 90th $41 to $8,128Professionalmedian $219 · 10th to 90th $91 to $708
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 $1,348.96 Median $5,888.44 Typical High $10,964.78 | Facility | None | $1,348.96 | $5,888.44 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $691.83 | Professional | None | $79.43 | $199.53 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $371.54 | Professional | None | $181.97 | $213.80 | $371.54 |
CDPHP Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $912.01 | Professional | None | $131.83 | $131.83 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $128.82 Typical High $537.03 | Facility | None | $102.33 | $128.82 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $302.00 Typical High $1,174.90 | Professional | None | $67.61 | $302.00 | $1,174.90 |
Emblem Health Setting Facility Modifier None Typical Low $54.95 Median $89.13 Typical High $295.12 | Facility | None | $54.95 | $89.13 | $295.12 |
Emblem Health Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,288.25 | Professional | None | $660.69 | $870.96 | $1,288.25 |
Excellus BCBS Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $707.95 | Professional | None | $524.81 | $602.56 | $707.95 |
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 $100.00 Median $100.00 Typical High $1,148.15 | Professional | None | $100.00 | $100.00 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $3,981.07 Typical High $10,232.93 | Facility | None | $1,479.11 | $3,981.07 | $10,232.93 |
United Setting Professional Modifier None Typical Low $72.44 Median $275.42 Typical High $912.01 | Professional | None | $72.44 | $275.42 | $912.01 |
Univera Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $295.12 | Facility | None | $40.74 | $40.74 | $295.12 |
Univera Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $707.95 | Professional | None | $524.81 | $602.56 | $707.95 |
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 $39.81 Median $100.00 Typical High $338.84 | Professional | 52 · Reduced service | $39.81 | $100.00 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $39.81 Typical High $134.90 | Professional | 53 · Discontinued | $16.22 | $39.81 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $147.91 Typical High $512.86 | Professional | 54 · Surgery only | $60.26 | $147.91 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $29.51 Typical High $102.33 | Professional | 55 · Aftercare only | $12.02 | $29.51 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $19.95 Typical High $67.61 | Professional | 56 · Pre-op care only | $7.94 | $19.95 | $67.61 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $323.59 Typical High $891.25 | Professional | 53 · Discontinued | $251.19 | $323.59 | $891.25 |
Where New York sits
The same service costs 9.5 times more in Washington than in Washington, DC. 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· 30th of 51
$219
WA $933DC $97.72
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.