How much rates vary
Facilitymedian $3,236 · 10th to 90th $794 to $7,586Professionalmedian $3,802 · 10th to 90th $302 to $4,898
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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $426.58 | Professional | None | $281.84 | $281.84 | $426.58 |
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 $3,715.35 Median $4,365.16 Typical High $4,897.79 | Professional | None | $3,715.35 | $4,365.16 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,344.23 Median $2,754.23 Typical High $3,090.30 | Professional | 62 · Two surgeons | $2,344.23 | $2,754.23 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $691.83 Typical High $794.33 | Professional | 80 · Assistant surgeon | $588.84 | $691.83 | $794.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $524.81 Median $602.56 Typical High $691.83 | Professional | AS · PA/NP assist | $524.81 | $602.56 | $691.83 |
CDPHP Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $2,754.23 | Facility | None | $794.33 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $691.83 | Professional | None | $302.00 | $302.00 | $691.83 |
Emblem Health Setting Facility Modifier None Typical Low $407.38 Median $741.31 Typical High $1,659.59 | Facility | None | $407.38 | $741.31 | $1,659.59 |
Emblem Health Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $851.14 | Professional | None | $478.63 | $478.63 | $851.14 |
Excellus BCBS Setting Professional Modifier None Typical Low $512.86 Median $891.25 Typical High $1,288.25 | Professional | None | $512.86 | $891.25 | $1,288.25 |
MVP Health Care Setting Professional Modifier None Typical Low $676.08 Median $16,218.10 Typical High $16,218.10 | Professional | None | $676.08 | $16,218.10 | $16,218.10 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $891.25 | Professional | None | $281.84 | $346.74 | $891.25 |
Univera Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $1,778.28 | Facility | None | $602.56 | $1,230.27 | $1,778.28 |
Univera Setting Professional Modifier None Typical Low $512.86 Median $891.25 Typical High $1,288.25 | Professional | None | $512.86 | $891.25 | $1,288.25 |
3 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 $208.93 Median $208.93 Typical High $288.40 | Professional | 54 · Surgery only | $208.93 | $208.93 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $41.69 Typical High $57.54 | Professional | 55 · Aftercare only | $41.69 | $41.69 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.18 Typical High $38.02 | Professional | 56 · Pre-op care only | $28.18 | $28.18 | $38.02 |
Where New York sits
The same service costs 15.1 times more in New York 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· 1st of 51
$3,802
NY $3,802HI $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.