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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $501.19 Typical High $724.44 | Professional | None | $407.38 | $501.19 | $724.44 |
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 $186.21 Median $218.78 Typical High $281.84 | Professional | None | $186.21 | $218.78 | $281.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $117.49 Median $138.04 Typical High $177.83 | Professional | 62 · Two surgeons | $117.49 | $138.04 | $177.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $30.20 Median $35.48 Typical High $44.67 | Professional | 80 · Assistant surgeon | $30.20 | $35.48 | $44.67 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $26.30 Median $30.90 Typical High $39.81 | Professional | AS · PA/NP assist | $26.30 | $30.90 | $39.81 |
CDPHP Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $2,754.23 | Facility | None | $794.33 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $354.81 Typical High $1,412.54 | Professional | None | $346.74 | $354.81 | $1,412.54 |
Emblem Health Setting Facility Modifier None Typical Low $239.88 Median $616.60 Typical High $1,412.54 | Facility | None | $239.88 | $616.60 | $1,412.54 |
Emblem Health Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $1,412.54 | Professional | None | $263.03 | $323.59 | $1,412.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,148.15 | Professional | None | $562.34 | $776.25 | $1,148.15 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $169.82 Median $331.13 Typical High $1,258.93 | Professional | None | $169.82 | $331.13 | $1,258.93 |
Univera Setting Facility Modifier None Typical Low $602.56 Median $933.25 Typical High $1,621.81 | Facility | None | $602.56 | $933.25 | $1,621.81 |
Univera Setting Professional Modifier None Typical Low $512.86 Median $776.25 Typical High $1,023.29 | Professional | None | $512.86 | $776.25 | $1,023.29 |
3 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 54 · Surgery only Typical Low $309.03 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $309.03 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $61.66 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $40.74 | $50.12 | $50.12 |
Where New York sits
The same service costs 9.8 times more in Indiana than in Hawaii. 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· 50th of 51
$245
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.