How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,148 to $13,490Professionalmedian $3,802 · 10th to 90th $1,660 to $5,623
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 $1,122.02 Median $1,122.02 Typical High $2,884.03 | Professional | None | $1,122.02 | $1,122.02 | $2,884.03 |
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 $3,235.94 Median $3,890.45 Typical High $4,466.84 | Professional | None | $3,235.94 | $3,890.45 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $630.96 Typical High $724.44 | Professional | 80 · Assistant surgeon | $512.86 | $630.96 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $457.09 Median $549.54 Typical High $630.96 | Professional | AS · PA/NP assist | $457.09 | $549.54 | $630.96 |
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 $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,388.44 | Facility | None | $851.14 | $1,778.28 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,187.76 Typical High $7,762.47 | Professional | None | $2,089.30 | $2,187.76 | $7,762.47 |
Emblem Health Setting Facility Modifier None Typical Low $3,801.89 Median $6,309.57 Typical High $12,882.50 | Facility | None | $3,801.89 | $6,309.57 | $12,882.50 |
Emblem Health Setting Professional Modifier None Typical Low $3,467.37 Median $4,168.69 Typical High $7,244.36 | Professional | None | $3,467.37 | $4,168.69 | $7,244.36 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $3,801.89 Typical High $5,754.40 | Professional | None | $1,659.59 | $3,801.89 | $5,754.40 |
MVP Health Care Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
MVP Health Care Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
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 $2,290.87 Median $3,801.89 Typical High $8,511.38 | Professional | None | $2,290.87 | $3,801.89 | $8,511.38 |
Univera Setting Facility Modifier None Typical Low $1,548.82 Median $2,951.21 Typical High $5,370.32 | Facility | None | $1,548.82 | $2,951.21 | $5,370.32 |
Univera Setting Professional Modifier None Typical Low $1,548.82 Median $3,801.89 Typical High $5,754.40 | Professional | None | $1,548.82 | $3,801.89 | $5,754.40 |
6 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 $562.34 Median $562.34 Typical High $1,412.54 | Professional | 52 · Reduced service | $562.34 | $562.34 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $575.44 | Professional | 53 · Discontinued | $223.87 | $223.87 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $2,137.96 | Professional | 54 · Surgery only | $831.76 | $831.76 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $426.58 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $288.40 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $288.40 |
Highmark BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 62 · Two surgeons | $2,951.21 | $2,951.21 | $2,951.21 |
Where New York sits
The same service costs 5.6 times more in Alaska than in South Carolina. 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· 13th of 51
$3,802
AK $9,550SC $1,698
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.