How much rates vary
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,513.56 Typical High $1,513.56 | Professional | None | $851.14 | $1,513.56 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,290.87 | Professional | None | $1,778.28 | $2,089.30 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $331.13 Typical High $371.54 | Professional | 80 · Assistant surgeon | $281.84 | $331.13 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $288.40 Typical High $323.59 | Professional | AS · PA/NP assist | $245.47 | $288.40 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $7,585.78 Typical High $15,488.17 | Facility | None | $1,737.80 | $7,585.78 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,659.59 | Professional | None | $776.25 | $1,122.02 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,073.80 | $14,125.38 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $2,884.03 | Professional | None | $851.14 | $1,288.25 | $2,884.03 |
Univera Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $1,548.82 | Facility | None | $776.25 | $776.25 | $1,548.82 |
Univera Setting Professional Modifier None Typical Low $660.69 Median $1,122.02 Typical High $1,659.59 | Professional | None | $660.69 | $1,122.02 | $1,659.59 |
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 $426.58 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $426.58 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $169.82 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $645.65 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $128.82 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $85.11 | $151.36 | $151.36 |
Where New York sits
The same service costs 5.9 times more in Texas than in Kentucky. 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
$1,905
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.