How much rates vary
Facilitymedian $295 · 10th to 90th $158 to $933Professionalmedian $219 · 10th to 90th $158 to $339
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 $158.49 Median $218.78 Typical High $218.78 | Facility | None | $158.49 | $218.78 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $173.78 | Professional | None | $100.00 | $117.49 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $467.74 | Professional | None | $100.00 | $134.90 | $467.74 |
CDPHP Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Emblem Health Setting Facility Modifier None Typical Low $275.42 Median $446.68 Typical High $1,047.13 | Facility | None | $275.42 | $446.68 | $1,047.13 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $512.86 | Professional | None | $302.00 | $302.00 | $512.86 |
Excellus BCBS Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $436.52 | Professional | None | $218.78 | $257.04 | $436.52 |
Highmark BCBS Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $645.65 | Facility | None | $575.44 | $575.44 | $645.65 |
Highmark BCBS Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
United Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $954.99 | Facility | None | $660.69 | $776.25 | $954.99 |
United Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $331.13 | Professional | None | $173.78 | $239.88 | $331.13 |
Univera Setting Facility Modifier None Typical Low $257.04 Median $295.12 Typical High $295.12 | Facility | None | $257.04 | $295.12 | $295.12 |
Univera Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $436.52 | Professional | None | $151.36 | $257.04 | $436.52 |
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 $79.43 Median $79.43 Typical High $109.65 | Professional | 52 · Reduced service | $79.43 | $79.43 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $43.65 | Professional | 53 · Discontinued | $31.62 | $31.62 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $33.11 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $21.88 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $21.88 |
Fidelis Setting Professional Modifier XU · Unusual separate service Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | XU · Unusual separate service | $338.84 | $338.84 | $338.84 |
Where New York sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 23rd of 51
$219
AK $501CT $158
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.