How much rates vary
Facilitymedian $3,162 · 10th to 90th $562 to $7,586Professionalmedian $537 · 10th to 90th $417 to $1,023
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 $5,248.07 Typical High $10,471.29 | Facility | None | $1,819.70 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $676.08 | Professional | None | $645.65 | $645.65 | $676.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $776.25 | Professional | None | $446.68 | $524.81 | $776.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $281.84 Median $331.13 Typical High $489.78 | Professional | 62 · Two surgeons | $281.84 | $331.13 | $489.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $83.18 Typical High $123.03 | Professional | 80 · Assistant surgeon | $70.79 | $83.18 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $74.13 Typical High $107.15 | Professional | AS · PA/NP assist | $63.10 | $74.13 | $107.15 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,479.11 Typical High $1,862.09 | Facility | None | $707.95 | $1,479.11 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $537.03 Typical High $1,412.54 | Professional | None | $524.81 | $537.03 | $1,412.54 |
Emblem Health Setting Facility Modifier None Typical Low $181.97 Median $616.60 Typical High $1,995.26 | Facility | None | $181.97 | $616.60 | $1,995.26 |
Emblem Health Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $1,000.00 | Professional | None | $549.54 | $602.56 | $1,000.00 |
Excellus BCBS Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $741.31 | Professional | None | $407.38 | $489.78 | $741.31 |
MVP Health Care Setting Facility Modifier None Typical Low $630.96 Median $5,754.40 Typical High $36,307.81 | Facility | None | $630.96 | $5,754.40 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $1,513.56 | Professional | None | $398.11 | $398.11 | $1,513.56 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,318.26 Typical High $4,466.84 | Facility | None | $363.08 | $1,318.26 | $4,466.84 |
United Setting Professional Modifier None Typical Low $346.74 Median $660.69 Typical High $1,621.81 | Professional | None | $346.74 | $660.69 | $1,621.81 |
Univera Setting Facility Modifier None Typical Low $524.81 Median $549.54 Typical High $2,691.53 | Facility | None | $524.81 | $549.54 | $2,691.53 |
Univera Setting Professional Modifier None Typical Low $407.38 Median $512.86 Typical High $741.31 | Professional | None | $407.38 | $512.86 | $741.31 |
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 $323.59 Median $323.59 Typical High $338.84 | Professional | 52 · Reduced service | $323.59 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | 53 · Discontinued | $131.83 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $501.19 | Professional | 54 · Surgery only | $489.78 | $489.78 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $100.00 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $67.61 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $67.61 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $331.13 Typical High $501.19 | Professional | 53 · Discontinued | $309.03 | $331.13 | $501.19 |
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
$550
AK $2,399UT $490
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.