How much rates vary
Facilitymedian $60 · 10th to 90th $56 to $105Professionalmedian $60 · 10th to 90th $56 to $95
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 $56.23 Median $64.57 Typical High $162.18 | Facility | None | $56.23 | $64.57 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $57.54 | Facility | None | $56.23 | $56.23 | $57.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
CDPHP Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $75.86 Typical High $91.20 | Facility | None | $64.57 | $75.86 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Emblem Health Setting Facility Modifier None Typical Low $57.54 Median $69.18 Typical High $190.55 | Facility | None | $57.54 | $69.18 | $190.55 |
Emblem Health Setting Professional Modifier None Typical Low $51.29 Median $60.26 Typical High $60.26 | Professional | None | $51.29 | $60.26 | $60.26 |
Excellus BCBS Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $63.10 | Facility | None | $56.23 | $56.23 | $63.10 |
Excellus BCBS Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $63.10 | Professional | None | $56.23 | $56.23 | $63.10 |
Highmark BCBS Setting Facility Modifier None Typical Low $43.65 Median $93.33 Typical High $120.23 | Facility | None | $43.65 | $93.33 | $120.23 |
Highmark BCBS Setting Professional Modifier None Typical Low $60.26 Median $66.07 Typical High $93.33 | Professional | None | $60.26 | $66.07 | $93.33 |
MVP Health Care Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $199.53 | Facility | None | $54.95 | $54.95 | $199.53 |
MVP Health Care Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $75.86 | Professional | None | $56.23 | $60.26 | $75.86 |
Univera Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $63.10 | Facility | None | $56.23 | $56.23 | $63.10 |
Univera Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $63.10 | Professional | None | $56.23 | $56.23 | $63.10 |
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 $30.20 Median $30.20 Typical High $30.20 | Professional | 52 · Reduced service | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.03 |
Where New York sits
The same service costs 2.0 times more in Wyoming than in Hawaii. 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· 48th of 51
$60.26
WY $83.18HI $41.69
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.