How much rates vary
Facilitymedian $115 · 10th to 90th $15 to $295Professionalmedian $72 · 10th to 90th $32 to $224
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 $42.66 Median $123.03 Typical High $288.40 | Facility | None | $42.66 | $123.03 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $58.88 Typical High $97.72 | Professional | None | $42.66 | $58.88 | $97.72 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $295.12 | Facility | None | $114.82 | $114.82 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $83.18 Typical High $257.04 | Professional | None | $31.62 | $83.18 | $257.04 |
CDPHP Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $245.47 Typical High $331.13 | Facility | None | $112.20 | $245.47 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $549.54 | Professional | None | $60.26 | $60.26 | $549.54 |
Emblem Health Setting Facility Modifier None Typical Low $52.48 Median $114.82 Typical High $257.04 | Facility | None | $52.48 | $114.82 | $257.04 |
Emblem Health Setting Professional Modifier None Typical Low $45.71 Median $67.61 Typical High $223.87 | Professional | None | $45.71 | $67.61 | $223.87 |
Excellus BCBS Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Excellus BCBS Setting Professional Modifier None Typical Low $15.14 Median $75.86 Typical High $125.89 | Professional | None | $15.14 | $75.86 | $125.89 |
Highmark BCBS Setting Facility Modifier None Typical Low $46.77 Median $125.89 Typical High $512.86 | Facility | None | $46.77 | $125.89 | $512.86 |
Highmark BCBS Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
MVP Health Care Setting Facility Modifier None Typical Low $19.50 Median $147.91 Typical High $602.56 | Facility | None | $19.50 | $147.91 | $602.56 |
MVP Health Care Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $234.42 | Professional | None | $60.26 | $60.26 | $234.42 |
United Setting Facility Modifier None Typical Low $102.33 Median $114.82 Typical High $144.54 | Facility | None | $102.33 | $114.82 | $144.54 |
United Setting Professional Modifier None Typical Low $47.86 Median $54.95 Typical High $169.82 | Professional | None | $47.86 | $54.95 | $169.82 |
Univera Setting Facility Modifier None Typical Low $15.14 Median $15.14 Typical High $131.83 | Facility | None | $15.14 | $15.14 | $131.83 |
Univera Setting Professional Modifier None Typical Low $15.14 Median $75.86 Typical High $125.89 | Professional | None | $15.14 | $75.86 | $125.89 |
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 $21.38 Median $21.38 Typical High $48.98 | Professional | 52 · Reduced service | $21.38 | $21.38 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $19.50 | Professional | 53 · Discontinued | $8.51 | $8.51 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $31.62 Typical High $72.44 | Professional | 54 · Surgery only | $31.62 | $31.62 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $14.45 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $9.77 |
Fidelis Setting Professional Modifier 90 · Outside lab Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 90 · Outside lab | $7.59 | $7.59 | $7.59 |
Where New York sits
The same service costs 4.9 times more in Alaska than in Georgia. 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
$75.86
AK $224GA $45.71
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.