How much rates vary
Facilitymedian $5,623 · 10th to 90th $955 to $15,849Professionalmedian $759 · 10th to 90th $575 to $1,445
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,659.59 | Professional | None | $831.76 | $831.76 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $20,892.96 | Facility | None | $1,862.09 | $8,709.64 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,348.96 | Professional | None | $602.56 | $724.44 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $114.82 Typical High $223.87 | Professional | 80 · Assistant surgeon | $97.72 | $114.82 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $100.00 Typical High $186.21 | Professional | AS · PA/NP assist | $83.18 | $100.00 | $186.21 |
CDPHP Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,737.80 Typical High $2,754.23 | Facility | None | $851.14 | $1,737.80 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $2,570.40 | Professional | None | $758.58 | $758.58 | $2,570.40 |
Emblem Health Setting Facility Modifier None Typical Low $758.58 Median $1,000.00 Typical High $2,818.38 | Facility | None | $758.58 | $1,000.00 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,513.56 | Professional | None | $741.31 | $870.96 | $1,513.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $1,000.00 | Professional | None | $478.63 | $645.65 | $1,000.00 |
MVP Health Care Setting Facility Modifier None Typical Low $851.14 Median $27,542.29 Typical High $43,651.58 | Facility | None | $851.14 | $27,542.29 | $43,651.58 |
MVP Health Care Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,148.15 | $1,905.46 |
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 $575.44 Median $851.14 Typical High $2,187.76 | Professional | None | $575.44 | $851.14 | $2,187.76 |
Univera Setting Facility Modifier None Typical Low $512.86 Median $691.83 Typical High $1,445.44 | Facility | None | $512.86 | $691.83 | $1,445.44 |
Univera Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $1,000.00 | Professional | None | $478.63 | $645.65 | $1,000.00 |
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 $416.87 Median $416.87 Typical High $489.78 | Professional | 52 · Reduced service | $416.87 | $416.87 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $169.82 Typical High $194.98 | Professional | 53 · Discontinued | $169.82 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $741.31 | Professional | 54 · Surgery only | $630.96 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $97.72 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $97.72 |
Where New York sits
The same service costs 3.8 times more in Wisconsin than in New York. 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· 51st of 51
$776
WI $2,951NY $776
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.