How much rates vary
Facilitymedian $3,311 · 10th to 90th $871 to $7,762Professionalmedian $234 · 10th to 90th $186 to $1,023
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 $537.03 Median $3,235.94 Typical High $3,235.94 | Professional | None | $537.03 | $3,235.94 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $218.78 Typical High $309.03 | Professional | None | $181.97 | $218.78 | $309.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $114.82 Median $138.04 Typical High $194.98 | Professional | 62 · Two surgeons | $114.82 | $138.04 | $194.98 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $29.51 Median $34.67 Typical High $47.86 | Professional | 80 · Assistant surgeon | $29.51 | $34.67 | $47.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $25.70 Median $30.90 Typical High $43.65 | Professional | AS · PA/NP assist | $25.70 | $30.90 | $43.65 |
CDPHP Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | None | $524.81 | $524.81 | $524.81 |
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 $398.11 Median $407.38 Typical High $1,412.54 | Professional | None | $398.11 | $407.38 | $1,412.54 |
Emblem Health Setting Facility Modifier None Typical Low $363.08 Median $933.25 Typical High $1,621.81 | Facility | None | $363.08 | $933.25 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $1,621.81 | Professional | None | $398.11 | $489.78 | $1,621.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $1,380.38 | Professional | None | $645.65 | $891.25 | $1,380.38 |
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 $288.40 Median $467.74 Typical High $1,202.26 | Professional | None | $288.40 | $467.74 | $1,202.26 |
Univera Setting Facility Modifier None Typical Low $676.08 Median $1,230.27 Typical High $2,137.96 | Facility | None | $676.08 | $1,230.27 | $2,137.96 |
Univera Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $1,318.26 | Professional | None | $575.44 | $891.25 | $1,318.26 |
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 $407.38 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $407.38 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $81.28 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $53.70 | $323.59 | $323.59 |
Where New York sits
The same service costs 7.1 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
$245
WI $1,738NY $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.