How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,072 to $13,490Professionalmedian $282 · 10th to 90th $224 to $759
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 $512.86 Median $5,248.07 Typical High $9,772.37 | Facility | None | $512.86 | $5,248.07 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $478.63 Typical High $912.01 | Professional | None | $269.15 | $478.63 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,456.54 Typical High $18,620.87 | Facility | None | $1,659.59 | $6,456.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $575.44 | Professional | None | $223.87 | $263.03 | $575.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $138.04 Median $165.96 Typical High $363.08 | Professional | 62 · Two surgeons | $138.04 | $165.96 | $363.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $35.48 Median $41.69 Typical High $95.50 | Professional | 80 · Assistant surgeon | $35.48 | $41.69 | $95.50 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $30.90 Median $36.31 Typical High $81.28 | Professional | AS · PA/NP assist | $30.90 | $36.31 | $81.28 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,890.45 Typical High $7,585.78 | Facility | None | $1,318.26 | $3,890.45 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $1,318.26 | Professional | None | $295.12 | $407.38 | $1,318.26 |
Emblem Health Setting Facility Modifier None Typical Low $323.59 Median $602.56 Typical High $1,230.27 | Facility | None | $323.59 | $602.56 | $1,230.27 |
Emblem Health Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $870.96 | Professional | None | $323.59 | $380.19 | $870.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $831.76 | Professional | None | $223.87 | $316.23 | $831.76 |
Highmark BCBS Setting Facility Modifier None Typical Low $2,290.87 Median $8,709.64 Typical High $9,772.37 | Facility | None | $2,290.87 | $8,709.64 | $9,772.37 |
MVP Health Care Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $1,819.70 | Facility | None | $416.87 | $416.87 | $1,819.70 |
MVP Health Care Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $794.33 | Professional | None | $446.68 | $549.54 | $794.33 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,964.78 | Facility | None | $1,230.27 | $3,162.28 | $10,964.78 |
United Setting Professional Modifier None Typical Low $229.09 Median $407.38 Typical High $851.14 | Professional | None | $229.09 | $407.38 | $851.14 |
Univera Setting Facility Modifier None Typical Low $223.87 Median $281.84 Typical High $1,380.38 | Facility | None | $223.87 | $281.84 | $1,380.38 |
Univera Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $812.83 | Professional | None | $223.87 | $316.23 | $812.83 |
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 $134.90 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $134.90 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $53.70 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $204.17 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $40.74 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $26.92 | $47.86 | $47.86 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $213.80 Typical High $323.59 | Professional | 53 · Discontinued | $162.18 | $213.80 | $323.59 |
Where New York sits
The same service costs 10.0 times more in Oklahoma than in New York. 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· 51st of 51
$288
OK $2,884NY $288
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.