How much rates vary
Facilitymedian $339 · 10th to 90th $316 to $603Professionalmedian $316 · 10th to 90th $302 to $389
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 $338.84 Median $338.84 Typical High $436.52 | Facility | None | $338.84 | $338.84 | $436.52 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $501.19 | Professional | None | $338.84 | $338.84 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $323.59 | Facility | None | $316.23 | $316.23 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
CDPHP Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $354.81 Typical High $616.60 | Facility | None | $338.84 | $354.81 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $1,621.81 | Professional | None | $354.81 | $354.81 | $1,621.81 |
Emblem Health Setting Facility Modifier None Typical Low $323.59 Median $416.87 Typical High $724.44 | Facility | None | $323.59 | $416.87 | $724.44 |
Emblem Health Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $398.11 | Professional | None | $338.84 | $338.84 | $398.11 |
Excellus BCBS Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Highmark BCBS Setting Facility Modifier None Typical Low $223.87 Median $354.81 Typical High $588.84 | Facility | None | $223.87 | $354.81 | $588.84 |
Highmark BCBS Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $389.05 | Professional | None | $316.23 | $354.81 | $389.05 |
MVP Health Care Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $602.56 | Facility | None | $398.11 | $398.11 | $602.56 |
MVP Health Care Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $380.19 | Professional | None | $295.12 | $295.12 | $380.19 |
United Setting Facility Modifier None Typical Low $323.59 Median $338.84 Typical High $380.19 | Facility | None | $323.59 | $338.84 | $380.19 |
United Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $457.09 | Professional | None | $316.23 | $354.81 | $457.09 |
Univera Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $331.13 | Facility | None | $316.23 | $316.23 | $331.13 |
Univera Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
4 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 $169.82 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Where New York sits
The same service costs 2.9 times more in Arizona than in Alabama. 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· 40th of 51
$339
AZ $468AL $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.