How much rates vary
Facilitymedian $5,012 · 10th to 90th $708 to $13,183Professionalmedian $288 · 10th to 90th $224 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 $1,621.81 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,621.81 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $645.65 | Professional | None | $323.59 | $323.59 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $7,413.10 Typical High $14,454.40 | Facility | None | $1,659.59 | $7,413.10 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $512.86 | Professional | None | $229.09 | $275.42 | $512.86 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $144.54 Median $173.78 Typical High $323.59 | Professional | 62 · Two surgeons | $144.54 | $173.78 | $323.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $37.15 Median $44.67 Typical High $81.28 | Professional | 80 · Assistant surgeon | $37.15 | $44.67 | $81.28 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $32.36 Median $38.90 Typical High $72.44 | Professional | AS · PA/NP assist | $32.36 | $38.90 | $72.44 |
CDPHP Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,737.80 Typical High $2,754.23 | Facility | None | $676.08 | $1,737.80 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $295.12 Typical High $1,000.00 | Professional | None | $288.40 | $295.12 | $1,000.00 |
Emblem Health Setting Facility Modifier None Typical Low $316.23 Median $562.34 Typical High $1,148.15 | Facility | None | $316.23 | $562.34 | $1,148.15 |
Emblem Health Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $588.84 | Professional | None | $288.40 | $331.13 | $588.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $389.05 | Professional | None | $186.21 | $245.47 | $389.05 |
MVP Health Care Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
MVP Health Care Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $741.31 | Professional | None | $457.09 | $457.09 | $741.31 |
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 $218.78 Median $331.13 Typical High $851.14 | Professional | None | $218.78 | $331.13 | $851.14 |
Univera Setting Facility Modifier None Typical Low $199.53 Median $263.03 Typical High $1,258.93 | Facility | None | $199.53 | $263.03 | $1,258.93 |
Univera Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $389.05 | Professional | None | $186.21 | $245.47 | $389.05 |
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 $162.18 Median $162.18 Typical High $190.55 | Professional | 52 · Reduced service | $162.18 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $75.86 | Professional | 53 · Discontinued | $64.57 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $281.84 | Professional | 54 · Surgery only | $245.47 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $56.23 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | 56 · Pre-op care only | $32.36 | $32.36 | $38.02 |
Where New York sits
The same service costs 3.9 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
$302
WI $1,175NY $302
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.