How much rates vary
Facilitymedian $4,677 · 10th to 90th $490 to $11,482Professionalmedian $269 · 10th to 90th $219 to $457
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 $1,819.70 Median $6,165.95 Typical High $11,748.98 | Facility | None | $1,819.70 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $288.40 Typical High $323.59 | Professional | None | $281.84 | $288.40 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,778.28 | $6,760.83 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $380.19 | Professional | None | $229.09 | $269.15 | $380.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $37.15 Median $43.65 Typical High $58.88 | Professional | 80 · Assistant surgeon | $37.15 | $43.65 | $58.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $32.36 Median $38.02 Typical High $50.12 | Professional | AS · PA/NP assist | $32.36 | $38.02 | $50.12 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $1,621.81 Typical High $2,137.96 | Facility | None | $954.99 | $1,621.81 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $630.96 | Professional | None | $275.42 | $275.42 | $630.96 |
Emblem Health Setting Facility Modifier None Typical Low $281.84 Median $446.68 Typical High $977.24 | Facility | None | $281.84 | $446.68 | $977.24 |
Emblem Health Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $457.09 | Professional | None | $239.88 | $251.19 | $457.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $354.81 | Professional | None | $151.36 | $223.87 | $354.81 |
MVP Health Care Setting Facility Modifier None Typical Low $302.00 Median $3,235.94 Typical High $4,365.16 | Facility | None | $302.00 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $288.40 Median $446.68 Typical High $707.95 | Professional | None | $288.40 | $446.68 | $707.95 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $660.69 | Professional | None | $169.82 | $288.40 | $660.69 |
Univera Setting Facility Modifier None Typical Low $181.97 Median $251.19 Typical High $1,258.93 | Facility | None | $181.97 | $251.19 | $1,258.93 |
Univera Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $354.81 | Professional | None | $181.97 | $223.87 | $354.81 |
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 $141.25 Median $144.54 Typical High $151.36 | Professional | 52 · Reduced service | $141.25 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $60.26 | Professional | 53 · Discontinued | $57.54 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $213.80 Typical High $223.87 | Professional | 54 · Surgery only | $213.80 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $43.65 Typical High $45.71 | Professional | 55 · Aftercare only | $42.66 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.84 Typical High $30.20 | Professional | 56 · Pre-op care only | $28.18 | $28.84 | $30.20 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $147.91 Typical High $213.80 | Professional | 53 · Discontinued | $144.54 | $147.91 | $213.80 |
Where New York sits
The same service costs 4.8 times more in Alaska 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· 46th of 51
$275
AK $1,096UT $229
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.