How much rates vary
Facilitymedian $2,884 · 10th to 90th $631 to $5,888Professionalmedian $1,778 · 10th to 90th $162 to $2,291
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 $239.88 Median $269.15 Typical High $588.84 | Professional | None | $239.88 | $269.15 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $2,290.87 | Professional | None | $1,659.59 | $2,041.74 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,288.25 Typical High $1,445.44 | Professional | 62 · Two surgeons | $1,047.13 | $1,288.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $323.59 Typical High $371.54 | Professional | 80 · Assistant surgeon | $263.03 | $323.59 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $281.84 Typical High $323.59 | Professional | AS · PA/NP assist | $234.42 | $281.84 | $323.59 |
CDPHP Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
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 $190.55 Median $223.87 Typical High $891.25 | Professional | None | $190.55 | $223.87 | $891.25 |
Emblem Health Setting Facility Modifier None Typical Low $186.21 Median $316.23 Typical High $794.33 | Facility | None | $186.21 | $316.23 | $794.33 |
Emblem Health Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $588.84 | Professional | None | $204.17 | $229.09 | $588.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $288.40 | Professional | None | $128.82 | $169.82 | $288.40 |
MVP Health Care Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
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 $128.82 Median $177.83 Typical High $446.68 | Professional | None | $128.82 | $177.83 | $446.68 |
Univera Setting Facility Modifier None Typical Low $151.36 Median $213.80 Typical High $512.86 | Facility | None | $151.36 | $213.80 | $512.86 |
Univera Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $288.40 | Professional | None | $123.03 | $169.82 | $288.40 |
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 $177.83 Median $199.53 Typical High $199.53 | Professional | 54 · Surgery only | $177.83 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $35.48 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $23.99 | $26.92 | $26.92 |
Where New York sits
The same service costs 8.5 times more in New York 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· 1st of 51
$1,820
NY $1,820KY $214
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.