How much rates vary
Facilitymedian $2,570 · 10th to 90th $363 to $4,467Professionalmedian $12 · 10th to 90th $9 to $22
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 $12.59 Median $13.18 Typical High $27.54 | Facility | None | $12.59 | $13.18 | $27.54 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $13.80 | Professional | None | $12.59 | $12.59 | $13.80 |
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 $9.77 Median $11.75 Typical High $14.13 | Professional | None | $9.77 | $11.75 | $14.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $14.79 Median $17.78 Typical High $23.44 | Professional | 50 · Both sides | $14.79 | $17.78 | $23.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $6.31 Median $7.41 Typical High $11.48 | Professional | 62 · Two surgeons | $6.31 | $7.41 | $11.48 |
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 $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
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 $8.91 Median $14.79 Typical High $47.86 | Professional | None | $8.91 | $14.79 | $47.86 |
Emblem Health Setting Facility Modifier None Typical Low $12.02 Median $45.71 Typical High $100.00 | Facility | None | $12.02 | $45.71 | $100.00 |
Emblem Health Setting Professional Modifier None Typical Low $12.02 Median $13.49 Typical High $20.89 | Professional | None | $12.02 | $13.49 | $20.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $7.94 Median $10.00 Typical High $15.49 | Professional | None | $7.94 | $10.00 | $15.49 |
MVP Health Care Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $29.51 | Professional | None | $10.96 | $10.96 | $29.51 |
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 $8.32 Median $13.80 Typical High $32.36 | Professional | None | $8.32 | $13.80 | $32.36 |
Univera Setting Facility Modifier None Typical Low $6.17 Median $12.59 Typical High $38.02 | Facility | None | $6.17 | $12.59 | $38.02 |
Univera Setting Professional Modifier None Typical Low $6.61 Median $10.00 Typical High $14.45 | Professional | None | $6.61 | $10.00 | $14.45 |
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 $6.31 Median $6.31 Typical High $6.92 | Professional | 52 · Reduced service | $6.31 | $6.31 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $2.75 | Professional | 53 · Discontinued | $2.51 | $2.51 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $1.91 Typical High $2.04 | Professional | 55 · Aftercare only | $1.91 | $1.91 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.26 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.26 | $1.26 | $1.38 |
Where New York sits
The same service costs 12.3 times more in Florida 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· 50th of 51
$12.02
FL $132KY $10.72
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.