How much rates vary
Facilitymedian $525 · 10th to 90th $501 to $871Professionalmedian $537 · 10th to 90th $525 to $1,175
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 $524.81 Median $676.08 Typical High $1,548.82 | Facility | None | $524.81 | $676.08 | $1,548.82 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $537.03 | Facility | None | $524.81 | $524.81 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,288.25 | Professional | None | $537.03 | $537.03 | $1,288.25 |
CDPHP Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $707.95 Typical High $794.33 | Facility | None | $575.44 | $707.95 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $2,238.72 | Professional | None | $537.03 | $537.03 | $2,238.72 |
Emblem Health Setting Facility Modifier None Typical Low $501.19 Median $602.56 Typical High $1,122.02 | Facility | None | $501.19 | $602.56 | $1,122.02 |
Emblem Health Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $1,445.44 | Professional | None | $549.54 | $549.54 | $1,445.44 |
Excellus BCBS Setting Facility Modifier None Typical Low $478.63 Median $524.81 Typical High $524.81 | Facility | None | $478.63 | $524.81 | $524.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | None | $478.63 | $524.81 | $524.81 |
MVP Health Care Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $2,511.89 | Facility | None | $676.08 | $676.08 | $2,511.89 |
MVP Health Care Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $691.83 | Professional | None | $562.34 | $676.08 | $691.83 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
United Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $1,202.26 | Professional | None | $524.81 | $562.34 | $1,202.26 |
Univera Setting Facility Modifier None Typical Low $478.63 Median $524.81 Typical High $549.54 | Facility | None | $478.63 | $524.81 | $549.54 |
Univera Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | None | $478.63 | $524.81 | $524.81 |
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 52 · Reduced service Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $53.70 |
Where New York sits
The same service costs 5.0 times more in Wyoming than in Alabama. 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
$537
WY $1,175AL $234
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.