How much rates vary
Facilitymedian $4,169 · 10th to 90th $501 to $10,233Professionalmedian $363 · 10th to 90th $288 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 $1,513.56 Median $4,365.16 Typical High $8,128.31 | Facility | None | $1,513.56 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $1,148.15 | Professional | None | $407.38 | $407.38 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $676.08 | Professional | None | $302.00 | $363.08 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $549.54 Typical High $1,000.00 | Professional | 50 · Both sides | $446.68 | $549.54 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $57.54 Typical High $107.15 | Professional | 80 · Assistant surgeon | $47.86 | $57.54 | $107.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $51.29 Typical High $93.33 | Professional | AS · PA/NP assist | $42.66 | $51.29 | $93.33 |
CDPHP Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,737.80 Typical High $1,862.09 | Facility | None | $676.08 | $1,737.80 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $1,258.93 | Professional | None | $380.19 | $380.19 | $1,258.93 |
Emblem Health Setting Facility Modifier None Typical Low $363.08 Median $489.78 Typical High $1,412.54 | Facility | None | $363.08 | $489.78 | $1,412.54 |
Emblem Health Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $758.58 | Professional | None | $371.54 | $436.52 | $758.58 |
Excellus BCBS Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $501.19 | Professional | None | $239.88 | $316.23 | $501.19 |
MVP Health Care Setting Facility Modifier None Typical Low $457.09 Median $3,235.94 Typical High $4,365.16 | Facility | None | $457.09 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $954.99 | Professional | None | $338.84 | $338.84 | $954.99 |
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 $288.40 Median $416.87 Typical High $1,096.48 | Professional | None | $288.40 | $416.87 | $1,096.48 |
Univera Setting Facility Modifier None Typical Low $257.04 Median $338.84 Typical High $616.60 | Facility | None | $257.04 | $338.84 | $616.60 |
Univera Setting Professional Modifier None Typical Low $239.88 Median $316.23 Typical High $501.19 | Professional | None | $239.88 | $316.23 | $501.19 |
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 $204.17 Median $204.17 Typical High $245.47 | Professional | 52 · Reduced service | $204.17 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $97.72 | Professional | 53 · Discontinued | $81.28 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $371.54 | Professional | 54 · Surgery only | $309.03 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $74.13 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $48.98 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $48.98 |
Where New York sits
The same service costs 9.7 times more in Alabama than in Delaware. 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.
Physician feeFacility fee
AL $5,872DE $606
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.