How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,175 to $14,125Professionalmedian $1,622 · 10th to 90th $1,230 to $3,090
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 $1,819.70 Median $1,819.70 Typical High $3,548.13 | Professional | None | $1,819.70 | $1,819.70 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,548.82 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $245.47 Typical High $457.09 | Professional | 80 · Assistant surgeon | $204.17 | $245.47 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $213.80 Typical High $398.11 | Professional | AS · PA/NP assist | $177.83 | $213.80 | $398.11 |
CDPHP Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $5,623.41 | Professional | None | $1,621.81 | $1,621.81 | $5,623.41 |
Emblem Health Setting Facility Modifier None Typical Low $1,737.80 Median $2,511.89 Typical High $5,623.41 | Facility | None | $1,737.80 | $2,511.89 | $5,623.41 |
Emblem Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $3,235.94 | Professional | None | $1,584.89 | $1,862.09 | $3,235.94 |
Excellus BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $2,187.76 | Professional | None | $831.76 | $1,380.38 | $2,187.76 |
MVP Health Care Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
MVP Health Care Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $4,073.80 | Professional | None | $1,949.84 | $1,949.84 | $4,073.80 |
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 $1,230.27 Median $1,778.28 Typical High $4,677.35 | Professional | None | $1,230.27 | $1,778.28 | $4,677.35 |
Univera Setting Facility Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $5,888.44 | Facility | None | $1,096.48 | $1,445.44 | $5,888.44 |
Univera Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $2,187.76 | Professional | None | $831.76 | $1,380.38 | $2,187.76 |
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 $891.25 Median $891.25 Typical High $1,047.13 | Professional | 52 · Reduced service | $891.25 | $891.25 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | 53 · Discontinued | $363.08 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $316.23 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $208.93 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $208.93 |
Where New York sits
The same service costs 4.7 times more in Alaska than in Delaware. 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· 46th of 51
$1,622
AK $6,166DE $1,318
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.