How much rates vary
Facilitymedian $3,236 · 10th to 90th $646 to $7,762Professionalmedian $295 · 10th to 90th $195 to $380
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 $1,819.70 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $234.42 | Professional | None | $229.09 | $234.42 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,585.78 | Facility | None | $1,288.25 | $3,890.45 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $354.81 | Professional | None | $269.15 | $316.23 | $354.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $169.82 Median $199.53 Typical High $223.87 | Professional | 62 · Two surgeons | $169.82 | $199.53 | $223.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $51.29 Typical High $56.23 | Professional | 80 · Assistant surgeon | $42.66 | $51.29 | $56.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.02 Median $44.67 Typical High $48.98 | Professional | AS · PA/NP assist | $38.02 | $44.67 | $48.98 |
CDPHP Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,737.80 Typical High $2,754.23 | Facility | None | $676.08 | $1,737.80 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $204.17 Typical High $512.86 | Professional | None | $194.98 | $204.17 | $512.86 |
Emblem Health Setting Facility Modifier None Typical Low $223.87 Median $457.09 Typical High $933.25 | Facility | None | $223.87 | $457.09 | $933.25 |
Emblem Health Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $371.54 | Professional | None | $199.53 | $229.09 | $371.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $95.50 Median $173.78 Typical High $338.84 | Professional | None | $95.50 | $173.78 | $338.84 |
MVP Health Care Setting Facility Modifier None Typical Low $213.80 Median $4,365.16 Typical High $38,018.94 | Facility | None | $213.80 | $4,365.16 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $562.34 | Professional | None | $218.78 | $295.12 | $562.34 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,737.80 Typical High $6,606.93 | Facility | None | $575.44 | $1,737.80 | $6,606.93 |
United Setting Professional Modifier None Typical Low $128.82 Median $257.04 Typical High $588.84 | Professional | None | $128.82 | $257.04 | $588.84 |
Univera Setting Facility Modifier None Typical Low $112.20 Median $199.53 Typical High $1,122.02 | Facility | None | $112.20 | $199.53 | $1,122.02 |
Univera Setting Professional Modifier None Typical Low $112.20 Median $173.78 Typical High $338.84 | Professional | None | $112.20 | $173.78 | $338.84 |
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 $114.82 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $114.82 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $45.71 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 54 · Surgery only | $173.78 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $34.67 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $22.91 | $23.44 | $23.44 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $154.88 | Professional | 53 · Discontinued | $109.65 | $109.65 | $154.88 |
Where New York sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 24th of 51
$295
AK $832UT $162
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.