How much rates vary
Facilitymedian $3,715 · 10th to 90th $977 to $10,233Professionalmedian $1,698 · 10th to 90th $166 to $3,162
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 $1,513.56 Median $4,365.16 Typical High $12,022.64 | Facility | None | $1,513.56 | $4,365.16 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $2,089.30 Typical High $2,398.83 | Professional | None | $165.96 | $2,089.30 | $2,398.83 |
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 $1,479.11 Median $1,862.09 Typical High $3,388.44 | Professional | None | $1,479.11 | $1,862.09 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $295.12 Typical High $537.03 | Professional | 80 · Assistant surgeon | $239.88 | $295.12 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $263.03 Typical High $467.74 | Professional | AS · PA/NP assist | $208.93 | $263.03 | $467.74 |
CDPHP Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $13,489.63 | Facility | None | $4,466.84 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $2,754.23 | Professional | None | $213.80 | $213.80 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,737.80 Typical High $1,862.09 | Facility | None | $676.08 | $1,737.80 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $549.54 Typical High $3,548.13 | Professional | None | $147.91 | $549.54 | $3,548.13 |
Emblem Health Setting Facility Modifier None Typical Low $151.36 Median $199.53 Typical High $549.54 | Facility | None | $151.36 | $199.53 | $549.54 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $3,630.78 | Professional | None | $1,778.28 | $2,089.30 | $3,630.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,584.89 | $2,238.72 |
Highmark BCBS Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $3,090.30 | Professional | None | $181.97 | $181.97 | $3,090.30 |
MVP Health Care Setting Facility Modifier None Typical Low $190.55 Median $3,235.94 Typical High $4,365.16 | Facility | None | $190.55 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $3,715.35 | Professional | None | $162.18 | $162.18 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $19,498.45 | Facility | None | $1,318.26 | $4,073.80 | $19,498.45 |
United Setting Professional Modifier None Typical Low $134.90 Median $912.01 Typical High $3,090.30 | Professional | None | $134.90 | $912.01 | $3,090.30 |
Univera Setting Facility Modifier None Typical Low $104.71 Median $275.42 Typical High $2,089.30 | Facility | None | $104.71 | $275.42 | $2,089.30 |
Univera Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,584.89 | $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 $83.18 Median $954.99 Typical High $1,202.26 | Professional | 52 · Reduced service | $83.18 | $954.99 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $380.19 Typical High $478.63 | Professional | 53 · Discontinued | $33.11 | $380.19 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $1,445.44 Typical High $1,819.70 | Professional | 54 · Surgery only | $125.89 | $1,445.44 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $288.40 Typical High $363.08 | Professional | 55 · Aftercare only | $25.12 | $288.40 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $190.55 Typical High $239.88 | Professional | 56 · Pre-op care only | $16.60 | $190.55 | $239.88 |
Where New York sits
The same service costs 11.2 times more in Oklahoma than in Hawaii. 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· 30th of 51
$1,738
OK $2,818HI $251
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.