How much rates vary
Facilitymedian $2,630 · 10th to 90th $479 to $5,012Professionalmedian $513 · 10th to 90th $398 to $1,047
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 $8,128.31 | Facility | None | $1,513.56 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $1,548.82 | Professional | None | $489.78 | $537.03 | $1,548.82 |
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 $426.58 Median $501.19 Typical High $954.99 | Professional | None | $426.58 | $501.19 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $79.43 Typical High $154.88 | Professional | 80 · Assistant surgeon | $67.61 | $79.43 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $70.79 Typical High $134.90 | Professional | AS · PA/NP assist | $58.88 | $70.79 | $134.90 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $436.52 Typical High $1,479.11 | Facility | None | $229.09 | $436.52 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $1,995.26 | Professional | None | $630.96 | $660.69 | $1,995.26 |
Emblem Health Setting Facility Modifier None Typical Low $151.36 Median $562.34 Typical High $1,862.09 | Facility | None | $151.36 | $562.34 | $1,862.09 |
Emblem Health Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $1,000.00 | Professional | None | $524.81 | $602.56 | $1,000.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $676.08 | Professional | None | $323.59 | $426.58 | $676.08 |
MVP Health Care Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $4,786.30 | Facility | None | $588.84 | $588.84 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,202.26 | Professional | None | $741.31 | $812.83 | $1,202.26 |
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 $407.38 Median $630.96 Typical High $1,412.54 | Professional | None | $407.38 | $630.96 | $1,412.54 |
Univera Setting Facility Modifier None Typical Low $436.52 Median $489.78 Typical High $1,621.81 | Facility | None | $436.52 | $489.78 | $1,621.81 |
Univera Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $616.60 | Professional | None | $323.59 | $426.58 | $616.60 |
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 $245.47 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $245.47 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $97.72 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $371.54 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $53.70 |
Where New York sits
The same service costs 3.2 times more in Alaska than in Arkansas. 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· 42nd of 51
$525
AK $1,380AR $427
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.