How much rates vary
Facilitymedian $2,754 · 10th to 90th $490 to $5,248Professionalmedian $331 · 10th to 90th $275 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 $1,513.56 Median $4,570.88 Typical High $10,471.29 | Facility | None | $1,513.56 | $4,570.88 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $436.52 | Professional | None | $407.38 | $436.52 | $436.52 |
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 $275.42 Median $323.59 Typical High $489.78 | Professional | None | $275.42 | $323.59 | $489.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $43.65 Median $51.29 Typical High $77.62 | Professional | 80 · Assistant surgeon | $43.65 | $51.29 | $77.62 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.02 Median $44.67 Typical High $66.07 | Professional | AS · PA/NP assist | $38.02 | $44.67 | $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 $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,348.96 Typical High $1,862.09 | Facility | None | $512.86 | $1,348.96 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $870.96 | Professional | None | $323.59 | $323.59 | $870.96 |
Emblem Health Setting Facility Modifier None Typical Low $371.54 Median $489.78 Typical High $1,288.25 | Facility | None | $371.54 | $489.78 | $1,288.25 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $602.56 | Professional | None | $331.13 | $371.54 | $602.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $416.87 | Professional | None | $251.19 | $302.00 | $416.87 |
MVP Health Care Setting Facility Modifier None Typical Low $398.11 Median $4,365.16 Typical High $36,307.81 | Facility | None | $398.11 | $4,365.16 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $933.25 | Professional | None | $380.19 | $549.54 | $933.25 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,365.16 | Facility | None | $363.08 | $1,318.26 | $4,365.16 |
United Setting Professional Modifier None Typical Low $213.80 Median $398.11 Typical High $1,000.00 | Professional | None | $213.80 | $398.11 | $1,000.00 |
Univera Setting Facility Modifier None Typical Low $323.59 Median $331.13 Typical High $1,202.26 | Facility | None | $323.59 | $331.13 | $1,202.26 |
Univera Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $416.87 | Professional | None | $251.19 | $302.00 | $416.87 |
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 $204.17 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $204.17 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $83.18 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $309.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $61.66 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $40.74 | $43.65 | $43.65 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $302.00 | Professional | 53 · Discontinued | $190.55 | $204.17 | $302.00 |
Where New York sits
The same service costs 4.9 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· 48th of 51
$339
AK $1,445UT $295
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.