How much rates vary
Facilitymedian $2,455 · 10th to 90th $107 to $5,012Professionalmedian $93 · 10th to 90th $32 to $141
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 $38.02 Median $1,995.26 Typical High $7,762.47 | Facility | None | $38.02 | $1,995.26 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $66.07 Typical High $131.83 | Professional | None | $19.50 | $66.07 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $31.62 Median $87.10 Typical High $199.53 | Professional | None | $31.62 | $87.10 | $199.53 |
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 $85.11 Median $107.15 Typical High $158.49 | Professional | None | $85.11 | $107.15 | $158.49 |
CDPHP Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $141.25 | Professional | None | $51.29 | $51.29 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $63.10 Typical High $141.25 | Professional | None | $21.88 | $63.10 | $141.25 |
Emblem Health Setting Facility Modifier None Typical Low $34.67 Median $52.48 Typical High $120.23 | Facility | None | $34.67 | $52.48 | $120.23 |
Emblem Health Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $204.17 | Professional | None | $102.33 | $117.49 | $204.17 |
Excellus BCBS Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $128.82 | Professional | None | $67.61 | $97.72 | $128.82 |
Highmark BCBS Setting Facility Modifier None Typical Low $83.18 Median $275.42 Typical High $676.08 | Facility | None | $83.18 | $275.42 | $676.08 |
Highmark BCBS Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
MVP Health Care Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $131.83 | Professional | None | $66.07 | $66.07 | $131.83 |
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 $28.84 Median $57.54 Typical High $117.49 | Professional | None | $28.84 | $57.54 | $117.49 |
Univera Setting Facility Modifier None Typical Low $19.05 Median $40.74 Typical High $177.83 | Facility | None | $19.05 | $40.74 | $177.83 |
Univera Setting Professional Modifier None Typical Low $56.23 Median $97.72 Typical High $128.82 | Professional | None | $56.23 | $97.72 | $128.82 |
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 54 · Surgery only Typical Low $14.79 Median $50.12 Typical High $79.43 | Professional | 54 · Surgery only | $14.79 | $50.12 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $10.00 Typical High $16.22 | Professional | 55 · Aftercare only | $2.95 | $10.00 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $6.61 Typical High $10.72 | Professional | 56 · Pre-op care only | $1.95 | $6.61 | $10.72 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $58.88 Typical High $70.79 | Professional | 53 · Discontinued | $50.12 | $58.88 | $70.79 |
Where New York sits
The same service costs 2.8 times more in Alaska 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· 10th of 51
$97.72
AK $141KY $51.29
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.