How much rates vary
Facilitymedian $2,630 · 10th to 90th $447 to $5,012Professionalmedian $234 · 10th to 90th $178 to $631
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 $223.87 Median $269.15 Typical High $316.23 | Professional | None | $223.87 | $269.15 | $316.23 |
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 $177.83 Median $208.93 Typical High $467.74 | Professional | None | $177.83 | $208.93 | $467.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $112.20 Median $131.83 Typical High $302.00 | Professional | 62 · Two surgeons | $112.20 | $131.83 | $302.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.84 Median $33.88 Typical High $74.13 | Professional | 80 · Assistant surgeon | $28.84 | $33.88 | $74.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $25.12 Median $29.51 Typical High $66.07 | Professional | AS · PA/NP assist | $25.12 | $29.51 | $66.07 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $363.08 | Professional | None | $302.00 | $302.00 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $426.58 Typical High $1,479.11 | Facility | None | $229.09 | $426.58 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $275.42 Typical High $891.25 | Professional | None | $218.78 | $275.42 | $891.25 |
Emblem Health Setting Facility Modifier None Typical Low $218.78 Median $537.03 Typical High $870.96 | Facility | None | $218.78 | $537.03 | $870.96 |
Emblem Health Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $524.81 | Professional | None | $302.00 | $331.13 | $524.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $371.54 | Professional | None | $173.78 | $245.47 | $371.54 |
MVP Health Care Setting Facility Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $7,079.46 | Facility | None | $6,456.54 | $6,456.54 | $7,079.46 |
MVP Health Care Setting Professional Modifier None Typical Low $380.19 Median $4,786.30 Typical High $4,786.30 | Professional | None | $380.19 | $4,786.30 | $4,786.30 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $616.60 | Professional | None | $181.97 | $309.03 | $616.60 |
Univera Setting Facility Modifier None Typical Low $154.88 Median $245.47 Typical High $933.25 | Facility | None | $154.88 | $245.47 | $933.25 |
Univera Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $363.08 | Professional | None | $158.49 | $245.47 | $363.08 |
6 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 $107.15 Median $134.90 Typical High $158.49 | Professional | 52 · Reduced service | $107.15 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $54.95 Typical High $63.10 | Professional | 53 · Discontinued | $42.66 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $204.17 Typical High $234.42 | Professional | 54 · Surgery only | $162.18 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $40.74 Typical High $46.77 | Professional | 55 · Aftercare only | $32.36 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $26.92 Typical High $31.62 | Professional | 56 · Pre-op care only | $21.38 | $26.92 | $31.62 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $173.78 Typical High $263.03 | Professional | 53 · Discontinued | $128.82 | $173.78 | $263.03 |
Where New York sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 48th of 51
$245
AK $851MD $229
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.