How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,202 to $15,849Professionalmedian $4,266 · 10th to 90th $2,512 to $5,248
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 $3,548.13 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,548.13 | $3,981.07 | $3,981.07 |
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 $3,801.89 Median $4,570.88 Typical High $5,248.07 | Professional | None | $3,801.89 | $4,570.88 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $602.56 Median $724.44 Typical High $831.76 | Professional | 80 · Assistant surgeon | $602.56 | $724.44 | $831.76 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $524.81 Median $645.65 Typical High $741.31 | Professional | AS · PA/NP assist | $524.81 | $645.65 | $741.31 |
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 $4,466.84 | Facility | None | $851.14 | $1,778.28 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,691.53 Typical High $9,120.11 | Professional | None | $2,570.40 | $2,691.53 | $9,120.11 |
Emblem Health Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Facility | None | $3,548.13 | $3,548.13 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $2,238.72 Typical High $4,265.80 | Professional | None | $1,548.82 | $2,238.72 | $4,265.80 |
MVP Health Care Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $2,187.76 Median $2,951.21 Typical High $7,244.36 | Professional | None | $2,187.76 | $2,951.21 | $7,244.36 |
Univera Setting Facility Modifier None Typical Low $1,380.38 Median $2,089.30 Typical High $5,623.41 | Facility | None | $1,380.38 | $2,089.30 | $5,623.41 |
Univera Setting Professional Modifier None Typical Low $1,380.38 Median $2,238.72 Typical High $4,265.80 | Professional | None | $1,380.38 | $2,238.72 | $4,265.80 |
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 $1,737.80 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,737.80 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $707.95 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,630.27 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $524.81 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $354.81 | $398.11 | $398.11 |
Where New York sits
The same service costs 7.1 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· 8th of 51
$4,365
AK $10,471AR $1,479
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.