How much rates vary
Facilitymedian $4,074 · 10th to 90th $871 to $10,471Professionalmedian $407 · 10th to 90th $309 to $912
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 $6,606.93 Typical High $13,803.84 | Facility | None | $1,819.70 | $6,606.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $1,548.82 | Professional | None | $512.86 | $691.83 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,548.82 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $776.25 | Professional | None | $323.59 | $389.05 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $588.84 Typical High $1,148.15 | Professional | 50 · Both sides | $489.78 | $588.84 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $204.17 Median $245.47 Typical High $489.78 | Professional | 62 · Two surgeons | $204.17 | $245.47 | $489.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $63.10 Typical High $123.03 | Professional | 80 · Assistant surgeon | $51.29 | $63.10 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $54.95 Typical High $107.15 | Professional | AS · PA/NP assist | $45.71 | $54.95 | $107.15 |
CDPHP Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,737.80 Typical High $2,754.23 | Facility | None | $676.08 | $1,737.80 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $1,513.56 | Professional | None | $407.38 | $524.81 | $1,513.56 |
Emblem Health Setting Facility Modifier None Typical Low $436.52 Median $1,023.29 Typical High $1,905.46 | Facility | None | $436.52 | $1,023.29 | $1,905.46 |
Emblem Health Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $812.83 | Professional | None | $416.87 | $467.74 | $812.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $549.54 | Professional | None | $257.04 | $331.13 | $549.54 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,786.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,122.02 | Professional | None | $891.25 | $891.25 | $1,122.02 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,165.95 | Facility | None | $575.44 | $1,778.28 | $6,165.95 |
United Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $1,202.26 | Professional | None | $302.00 | $478.63 | $1,202.26 |
Univera Setting Facility Modifier None Typical Low $269.15 Median $281.84 Typical High $2,238.72 | Facility | None | $269.15 | $281.84 | $2,238.72 |
Univera Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $549.54 | Professional | None | $257.04 | $331.13 | $549.54 |
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 $257.04 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $257.04 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $104.71 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $389.05 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $77.62 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $51.29 | $69.18 | $69.18 |
Where New York sits
The same service costs 3.7 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
$437
WI $1,622NY $437
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.