How much rates vary
Facilitymedian $2,754 · 10th to 90th $631 to $5,248Professionalmedian $135 · 10th to 90th $105 to $372
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 $8,317.64 | Facility | None | $1,513.56 | $4,365.16 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $257.04 | Professional | None | $125.89 | $186.21 | $257.04 |
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 $109.65 Median $128.82 Typical High $147.91 | Professional | None | $109.65 | $128.82 | $147.91 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $69.18 Median $81.28 Typical High $93.33 | Professional | 62 · Two surgeons | $69.18 | $81.28 | $93.33 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $3,801.89 | Facility | None | $1,148.15 | $1,258.93 | $3,801.89 |
CDPHP Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,096.48 Typical High $1,737.80 | Facility | None | $616.60 | $1,096.48 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $194.98 Typical High $562.34 | Professional | None | $141.25 | $194.98 | $562.34 |
Emblem Health Setting Facility Modifier None Typical Low $426.58 Median $537.03 Typical High $1,096.48 | Facility | None | $426.58 | $537.03 | $1,096.48 |
Emblem Health Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $870.96 | Professional | None | $323.59 | $389.05 | $870.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $213.80 | Professional | None | $97.72 | $123.03 | $213.80 |
MVP Health Care Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,862.09 Typical High $4,897.79 | Facility | None | $549.54 | $1,862.09 | $4,897.79 |
United Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $426.58 | Professional | None | $112.20 | $186.21 | $426.58 |
Univera Setting Facility Modifier None Typical Low $104.71 Median $169.82 Typical High $575.44 | Facility | None | $104.71 | $169.82 | $575.44 |
Univera Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $208.93 | Professional | None | $89.13 | $123.03 | $208.93 |
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 $63.10 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $63.10 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $25.12 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $141.25 Typical High $141.25 | Professional | 54 · Surgery only | $95.50 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $19.05 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.59 | $18.62 | $18.62 |
Where New York sits
The same service costs 4.3 times more in Alaska than in New York. 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· 51st of 51
$141
AK $603NY $141
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.