How much rates vary
Facilitymedian $2,570 · 10th to 90th $363 to $4,467Professionalmedian $47 · 10th to 90th $37 to $89
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 $50.12 Median $52.48 Typical High $109.65 | Facility | None | $50.12 | $52.48 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $53.70 | Professional | None | $50.12 | $50.12 | $53.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $46.77 Typical High $60.26 | Professional | None | $38.90 | $46.77 | $60.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $58.88 Median $70.79 Typical High $87.10 | Professional | 50 · Both sides | $58.88 | $70.79 | $87.10 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $25.12 Median $29.51 Typical High $42.66 | Professional | 62 · Two surgeons | $25.12 | $29.51 | $42.66 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $1,202.26 Typical High $1,659.59 | Facility | None | $457.09 | $1,202.26 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $57.54 Typical High $173.78 | Professional | None | $35.48 | $57.54 | $173.78 |
Emblem Health Setting Facility Modifier None Typical Low $45.71 Median $66.07 Typical High $165.96 | Facility | None | $45.71 | $66.07 | $165.96 |
Emblem Health Setting Professional Modifier None Typical Low $45.71 Median $52.48 Typical High $79.43 | Professional | None | $45.71 | $52.48 | $79.43 |
Excellus BCBS Setting Professional Modifier None Typical Low $31.62 Median $38.90 Typical High $63.10 | Professional | None | $31.62 | $38.90 | $63.10 |
MVP Health Care Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $117.49 | Professional | None | $43.65 | $43.65 | $117.49 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,258.93 Typical High $4,365.16 | Facility | None | $363.08 | $1,258.93 | $4,365.16 |
United Setting Professional Modifier None Typical Low $32.36 Median $54.95 Typical High $125.89 | Professional | None | $32.36 | $54.95 | $125.89 |
Univera Setting Facility Modifier None Typical Low $24.55 Median $51.29 Typical High $165.96 | Facility | None | $24.55 | $51.29 | $165.96 |
Univera Setting Professional Modifier None Typical Low $26.30 Median $38.90 Typical High $57.54 | Professional | None | $26.30 | $38.90 | $57.54 |
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 $25.12 Median $25.12 Typical High $26.92 | Professional | 52 · Reduced service | $25.12 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.72 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.94 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.37 |
Where New York sits
The same service costs 4.7 times more in Wisconsin than in Kentucky. 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· 49th of 51
$47.86
WI $200KY $42.66
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.