How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,445 to $15,849Professionalmedian $1,202 · 10th to 90th $417 to $1,549
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 $6,025.60 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,025.60 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $645.65 | Professional | None | $416.87 | $416.87 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
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 $1,202.26 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,202.26 | $1,380.38 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $870.96 Typical High $977.24 | Professional | 62 · Two surgeons | $758.58 | $870.96 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $218.78 Typical High $251.19 | Professional | 80 · Assistant surgeon | $190.55 | $218.78 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $190.55 Typical High $218.78 | Professional | AS · PA/NP assist | $165.96 | $190.55 | $218.78 |
CDPHP Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $10,964.78 | Facility | None | $3,630.78 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $16,218.10 Typical High $32,359.37 | Facility | None | $2,238.72 | $16,218.10 | $32,359.37 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,202.26 | Professional | None | $512.86 | $512.86 | $1,202.26 |
Emblem Health Setting Facility Modifier None Typical Low $602.56 Median $1,148.15 Typical High $3,715.35 | Facility | None | $602.56 | $1,148.15 | $3,715.35 |
Emblem Health Setting Professional Modifier None Typical Low $562.34 Median $1,122.02 Typical High $1,995.26 | Professional | None | $562.34 | $1,122.02 | $1,995.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $562.34 Median $870.96 Typical High $1,318.26 | Professional | None | $562.34 | $870.96 | $1,318.26 |
MVP Health Care Setting Facility Modifier None Typical Low $1,023.29 Median $7,079.46 Typical High $48,977.88 | Facility | None | $1,023.29 | $7,079.46 | $48,977.88 |
MVP Health Care Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $16,595.87 | Facility | None | $1,380.38 | $4,786.30 | $16,595.87 |
United Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,348.96 | Professional | None | $660.69 | $812.83 | $1,348.96 |
Univera Setting Facility Modifier None Typical Low $562.34 Median $645.65 Typical High $1,318.26 | Facility | None | $562.34 | $645.65 | $1,318.26 |
Univera Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $1,318.26 | Professional | None | $562.34 | $812.83 | $1,318.26 |
2 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 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $478.63 | Professional | 54 · Surgery only | $309.03 | $309.03 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $446.68 |
Where New York sits
The same service costs 8.3 times more in South Dakota than in Kentucky. 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· 11th of 51
$1,202
SD $2,818KY $339
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.