How much rates vary
Facilitymedian $2,754 · 10th to 90th $447 to $5,129Professionalmedian $380 · 10th to 90th $191 to $724
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 $4,365.16 Typical High $8,128.31 | Facility | None | $1,348.96 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $281.84 Typical High $309.03 | Professional | None | $123.03 | $281.84 | $309.03 |
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 $338.84 Median $407.38 Typical High $724.44 | Professional | None | $338.84 | $407.38 | $724.44 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $575.44 | Professional | None | $251.19 | $251.19 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,445.44 Typical High $1,949.84 | Facility | None | $676.08 | $1,445.44 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Emblem Health Setting Facility Modifier None Typical Low $169.82 Median $213.80 Typical High $602.56 | Facility | None | $169.82 | $213.80 | $602.56 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $630.96 | Professional | None | $363.08 | $407.38 | $630.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $416.87 | Professional | None | $245.47 | $302.00 | $416.87 |
MVP Health Care Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $794.33 | Professional | None | $398.11 | $398.11 | $794.33 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,258.93 Typical High $4,365.16 | Facility | None | $363.08 | $1,258.93 | $4,365.16 |
United Setting Professional Modifier None Typical Low $128.82 Median $323.59 Typical High $1,071.52 | Professional | None | $128.82 | $323.59 | $1,071.52 |
Univera Setting Facility Modifier None Typical Low $134.90 Median $194.98 Typical High $363.08 | Facility | None | $134.90 | $194.98 | $363.08 |
Univera Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $389.05 | Professional | None | $229.09 | $295.12 | $389.05 |
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 $61.66 Median $123.03 Typical High $154.88 | Professional | 52 · Reduced service | $61.66 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $48.98 Typical High $61.66 | Professional | 53 · Discontinued | $24.55 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $181.97 Typical High $234.42 | Professional | 54 · Surgery only | $93.33 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $36.31 Typical High $46.77 | Professional | 55 · Aftercare only | $18.62 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $24.55 Typical High $30.90 | Professional | 56 · Pre-op care only | $12.30 | $24.55 | $30.90 |
Where New York sits
The same service costs 2.8 times more in Wisconsin than in Utah. 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· 20th of 51
$398
WI $813UT $288
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.