How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,202 to $15,849Professionalmedian $2,455 · 10th to 90th $1,950 to $4,898
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 $1,905.46 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,905.46 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $5,623.41 | Professional | None | $2,818.38 | $2,818.38 | $5,623.41 |
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 $2,041.74 Median $2,454.71 Typical High $4,570.88 | Professional | None | $2,041.74 | $2,454.71 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $389.05 Typical High $741.31 | Professional | 80 · Assistant surgeon | $323.59 | $389.05 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $346.74 Typical High $645.65 | Professional | AS · PA/NP assist | $288.40 | $346.74 | $645.65 |
CDPHP Setting Facility Modifier None Typical Low $18,620.87 Median $18,620.87 Typical High $18,620.87 | Facility | None | $18,620.87 | $18,620.87 | $18,620.87 |
CDPHP Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $4,168.69 | Facility | None | $851.14 | $1,778.28 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,630.27 Typical High $8,511.38 | Professional | None | $2,570.40 | $2,630.27 | $8,511.38 |
Emblem Health Setting Facility Modifier None Typical Low $2,511.89 Median $3,388.44 Typical High $9,120.11 | Facility | None | $2,511.89 | $3,388.44 | $9,120.11 |
Emblem Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $5,248.07 | Professional | None | $2,570.40 | $2,951.21 | $5,248.07 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,187.76 | $3,467.37 |
MVP Health Care Setting Facility Modifier None Typical Low $3,090.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $3,090.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $6,606.93 | Professional | None | $2,290.87 | $2,290.87 | $6,606.93 |
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 $1,995.26 Median $2,884.03 Typical High $7,585.78 | Professional | None | $1,995.26 | $2,884.03 | $7,585.78 |
Univera Setting Facility Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $4,168.69 | Facility | None | $1,778.28 | $2,344.23 | $4,168.69 |
Univera Setting Professional Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,187.76 | $3,467.37 |
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 $1,412.54 Median $1,412.54 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,412.54 | $1,412.54 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 53 · Discontinued | $562.34 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,089.30 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $501.19 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $281.84 | $281.84 | $338.84 |
Where New York sits
The same service costs 5.8 times more in Alaska than in Arkansas. 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
$2,570
AK $10,000AR $1,738
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.