How much rates vary
Facilitymedian $513 · 10th to 90th $513 to $832Professionalmedian $513 · 10th to 90th $490 to $562
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 $512.86 Median $660.69 Typical High $1,479.11 | Facility | None | $512.86 | $660.69 | $1,479.11 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $575.44 | Professional | None | $512.86 | $512.86 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $524.81 | Facility | None | $512.86 | $512.86 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | None | $489.78 | $512.86 | $512.86 |
CDPHP Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $676.08 Typical High $776.25 | Facility | None | $524.81 | $676.08 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $2,187.76 | Professional | None | $512.86 | $512.86 | $2,187.76 |
Emblem Health Setting Facility Modifier None Typical Low $489.78 Median $562.34 Typical High $1,778.28 | Facility | None | $489.78 | $562.34 | $1,778.28 |
Emblem Health Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $630.96 | Professional | None | $489.78 | $489.78 | $630.96 |
Excellus BCBS Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $524.81 | Facility | None | $512.86 | $512.86 | $524.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $524.81 | Professional | None | $512.86 | $512.86 | $524.81 |
MVP Health Care Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $1,071.52 | Facility | None | $630.96 | $630.96 | $1,071.52 |
MVP Health Care Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $630.96 | Professional | None | $537.03 | $630.96 | $630.96 |
United Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
United Setting Professional Modifier None Typical Low $512.86 Median $537.03 Typical High $691.83 | Professional | None | $512.86 | $537.03 | $691.83 |
Univera Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $537.03 | Facility | None | $512.86 | $512.86 | $537.03 |
Univera Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $524.81 | Professional | None | $512.86 | $512.86 | $524.81 |
5 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 $257.04 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $51.29 |
Where New York sits
The same service costs 1.6 times more in Arizona than in Wyoming. 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· 34th of 51
$513
AZ $813WY $513
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.