How much rates vary
Facilitymedian $3,715 · 10th to 90th $490 to $9,333Professionalmedian $224 · 10th to 90th $100 to $479
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 $1,318.26 Median $4,265.80 Typical High $8,128.31 | Facility | None | $1,318.26 | $4,265.80 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $295.12 Typical High $354.81 | Professional | None | $93.33 | $295.12 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $478.63 | Professional | None | $186.21 | $223.87 | $478.63 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $281.84 Median $338.84 Typical High $707.95 | Professional | 50 · Both sides | $281.84 | $338.84 | $707.95 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $3,801.89 Typical High $16,595.87 | Facility | None | $1,148.15 | $3,801.89 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $407.38 | Professional | None | $125.89 | $125.89 | $407.38 |
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 $72.44 Median $208.93 Typical High $588.84 | Professional | None | $72.44 | $208.93 | $588.84 |
Emblem Health Setting Facility Modifier None Typical Low $85.11 Median $141.25 Typical High $363.08 | Facility | None | $85.11 | $141.25 | $363.08 |
Emblem Health Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $501.19 | Professional | None | $288.40 | $309.03 | $501.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $354.81 | Professional | None | $162.18 | $229.09 | $354.81 |
MVP Health Care Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $630.96 | Professional | None | $245.47 | $245.47 | $630.96 |
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 $79.43 Median $218.78 Typical High $537.03 | Professional | None | $79.43 | $218.78 | $537.03 |
Univera Setting Facility Modifier None Typical Low $63.10 Median $114.82 Typical High $316.23 | Facility | None | $63.10 | $114.82 | $316.23 |
Univera Setting Professional Modifier None Typical Low $147.91 Median $229.09 Typical High $338.84 | Professional | None | $147.91 | $229.09 | $338.84 |
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 $46.77 Median $147.91 Typical High $177.83 | Professional | 52 · Reduced service | $46.77 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $58.88 Typical High $70.79 | Professional | 53 · Discontinued | $18.62 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $223.87 Typical High $269.15 | Professional | 54 · Surgery only | $70.79 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $44.67 Typical High $53.70 | Professional | 55 · Aftercare only | $14.13 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $29.51 Typical High $35.48 | Professional | 56 · Pre-op care only | $9.33 | $29.51 | $35.48 |
Where New York sits
The same service costs 3.6 times more in Wisconsin than in Nebraska. 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
$234
WI $537NE $148
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.