How much rates vary
Facilitymedian $3,162 · 10th to 90th $692 to $7,586Professionalmedian $427 · 10th to 90th $331 to $832
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 $457.09 Median $457.09 Typical High $954.99 | Professional | None | $457.09 | $457.09 | $954.99 |
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 $338.84 Median $407.38 Typical High $776.25 | Professional | None | $338.84 | $407.38 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $66.07 Typical High $123.03 | Professional | 80 · Assistant surgeon | $54.95 | $66.07 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $57.54 Typical High $107.15 | Professional | AS · PA/NP assist | $47.86 | $57.54 | $107.15 |
CDPHP Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
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 $426.58 Median $436.52 Typical High $1,479.11 | Professional | None | $426.58 | $436.52 | $1,479.11 |
Emblem Health Setting Facility Modifier None Typical Low $436.52 Median $602.56 Typical High $1,621.81 | Facility | None | $436.52 | $602.56 | $1,621.81 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $870.96 | Professional | None | $426.58 | $501.19 | $870.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $588.84 | Professional | None | $275.42 | $363.08 | $588.84 |
MVP Health Care Setting Facility Modifier None Typical Low $457.09 Median $4,786.30 Typical High $5,754.40 | Facility | None | $457.09 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,096.48 | Professional | None | $616.60 | $616.60 | $1,096.48 |
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 $331.13 Median $489.78 Typical High $1,258.93 | Professional | None | $331.13 | $489.78 | $1,258.93 |
Univera Setting Facility Modifier None Typical Low $295.12 Median $389.05 Typical High $812.83 | Facility | None | $295.12 | $389.05 | $812.83 |
Univera Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $588.84 | Professional | None | $275.42 | $363.08 | $588.84 |
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 $229.09 Median $229.09 Typical High $281.84 | Professional | 52 · Reduced service | $229.09 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | 53 · Discontinued | $91.20 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $416.87 | Professional | 54 · Surgery only | $338.84 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $56.23 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $56.23 |
Where New York sits
The same service costs 4.1 times more in Wisconsin than in Kentucky. 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
$447
WI $1,738KY $427
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.