How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,122 to $15,849Professionalmedian $2,188 · 10th to 90th $1,479 to $2,951
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,479.11 | $1,479.11 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $20,892.96 | Facility | None | $1,862.09 | $8,709.64 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $2,630.27 | Professional | None | $1,905.46 | $2,290.87 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $363.08 Typical High $416.87 | Professional | 80 · Assistant surgeon | $309.03 | $363.08 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $323.59 Typical High $363.08 | Professional | AS · PA/NP assist | $269.15 | $323.59 | $363.08 |
CDPHP Setting Facility Modifier None Typical Low $18,620.87 Median $18,620.87 Typical High $18,620.87 | Facility | None | $18,620.87 | $18,620.87 | $18,620.87 |
CDPHP Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,737.80 Typical High $5,888.44 | Professional | None | $1,659.59 | $1,737.80 | $5,888.44 |
Emblem Health Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $2,290.87 | Professional | None | $954.99 | $1,445.44 | $2,290.87 |
MVP Health Care Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $4,677.35 | Professional | None | $1,288.25 | $1,778.28 | $4,677.35 |
Univera Setting Facility Modifier None Typical Low $870.96 Median $1,122.02 Typical High $2,089.30 | Facility | None | $870.96 | $1,122.02 | $2,089.30 |
Univera Setting Professional Modifier None Typical Low $870.96 Median $1,445.44 Typical High $2,290.87 | Professional | None | $870.96 | $1,445.44 | $2,290.87 |
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 $741.31 Median $741.31 Typical High $1,122.02 | Professional | 52 · Reduced service | $741.31 | $741.31 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $457.09 | Professional | 53 · Discontinued | $295.12 | $295.12 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $338.84 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $223.87 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $223.87 |
Where New York sits
The same service costs 5.2 times more in Alaska than in Maryland. 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· 26th of 51
$2,239
AK $7,244MD $1,380
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.