How much rates vary
Facilitymedian $4,571 · 10th to 90th $794 to $11,220Professionalmedian $275 · 10th to 90th $214 to $724
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 $1,621.81 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,621.81 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $316.23 Typical High $630.96 | Professional | None | $263.03 | $316.23 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,309.57 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $524.81 | Professional | None | $229.09 | $269.15 | $524.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $36.31 Median $42.66 Typical High $85.11 | Professional | 80 · Assistant surgeon | $36.31 | $42.66 | $85.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $38.02 Typical High $74.13 | Professional | AS · PA/NP assist | $31.62 | $38.02 | $74.13 |
CDPHP Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $2,754.23 | Facility | None | $794.33 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $1,071.52 | Professional | None | $346.74 | $398.11 | $1,071.52 |
Emblem Health Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $1,513.56 | Facility | None | $295.12 | $1,023.29 | $1,513.56 |
Emblem Health Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $524.81 | Professional | None | $281.84 | $323.59 | $524.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $354.81 | Professional | None | $165.96 | $229.09 | $354.81 |
MVP Health Care Setting Facility Modifier None Typical Low $346.74 Median $3,235.94 Typical High $4,365.16 | Facility | None | $346.74 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $398.11 Median $1,698.24 Typical High $1,698.24 | Professional | None | $398.11 | $1,698.24 | $1,698.24 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,737.80 Typical High $6,165.95 | Facility | None | $575.44 | $1,737.80 | $6,165.95 |
United Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $758.58 | Professional | None | $213.80 | $338.84 | $758.58 |
Univera Setting Facility Modifier None Typical Low $234.42 Median $263.03 Typical High $2,290.87 | Facility | None | $234.42 | $263.03 | $2,290.87 |
Univera Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $331.13 | Professional | None | $165.96 | $229.09 | $331.13 |
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 $131.83 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $131.83 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $52.48 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $199.53 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $39.81 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.30 | $31.62 | $31.62 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $194.98 Typical High $275.42 | Professional | 53 · Discontinued | $141.25 | $194.98 | $275.42 |
Where New York sits
The same service costs 3.2 times more in Alaska than in Texas. 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
$282
AK $871TX $275
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.