How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,096 to $13,490Professionalmedian $1,514 · 10th to 90th $1,122 to $2,188
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 $12,589.25 | Facility | None | $1,819.70 | $6,309.57 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $2,041.74 | Professional | None | $977.24 | $977.24 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $7,413.10 Typical High $14,454.40 | Facility | None | $1,659.59 | $7,413.10 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,513.56 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $239.88 Typical High $275.42 | Professional | 80 · Assistant surgeon | $199.53 | $239.88 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $208.93 Typical High $239.88 | Professional | AS · PA/NP assist | $173.78 | $208.93 | $239.88 |
CDPHP Setting Facility Modifier None Typical Low $3,388.44 Median $3,467.37 Typical High $10,471.29 | Facility | None | $3,388.44 | $3,467.37 | $10,471.29 |
CDPHP Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $1,513.56 Median $1,584.89 Typical High $5,248.07 | Professional | None | $1,513.56 | $1,584.89 | $5,248.07 |
Emblem Health Setting Facility Modifier None Typical Low $1,479.11 Median $2,398.83 Typical High $4,897.79 | Facility | None | $1,479.11 | $2,398.83 | $4,897.79 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,621.81 | $2,754.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,445.44 | $2,187.76 |
MVP Health Care Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
MVP Health Care Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $1,023.29 Median $1,479.11 Typical High $3,311.31 | Professional | None | $1,023.29 | $1,479.11 | $3,311.31 |
Univera Setting Facility Modifier None Typical Low $1,071.52 Median $1,122.02 Typical High $2,754.23 | Facility | None | $1,071.52 | $1,122.02 | $2,754.23 |
Univera Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,445.44 | $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 $489.78 Median $489.78 Typical High $1,023.29 | Professional | 52 · Reduced service | $489.78 | $489.78 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $407.38 | Professional | 53 · Discontinued | $194.98 | $194.98 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $1,548.82 | Professional | 54 · Surgery only | $724.44 | $724.44 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $309.03 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $204.17 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $204.17 |
Where New York sits
The same service costs 4.7 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· 47th of 51
$1,549
AK $6,166AR $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.