How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,175 to $12,303Professionalmedian $813 · 10th to 90th $251 to $1,000
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 $1,621.81 Median $4,897.79 Typical High $12,589.25 | Facility | None | $1,621.81 | $4,897.79 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $707.95 Typical High $707.95 | Professional | None | $691.83 | $707.95 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,778.28 | $6,760.83 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,000.00 | Professional | None | $776.25 | $912.01 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,348.96 Typical High $1,513.56 | Professional | 50 · Both sides | $1,148.15 | $1,348.96 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $562.34 Typical High $630.96 | Professional | 62 · Two surgeons | $489.78 | $562.34 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $144.54 Typical High $162.18 | Professional | 80 · Assistant surgeon | $123.03 | $144.54 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $125.89 Typical High $141.25 | Professional | AS · PA/NP assist | $107.15 | $125.89 | $141.25 |
CDPHP Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $16,595.87 | Facility | None | $5,495.41 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $2,884.03 Typical High $6,025.60 | Facility | None | $1,000.00 | $2,884.03 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,445.44 | Professional | None | $537.03 | $537.03 | $1,445.44 |
Emblem Health Setting Facility Modifier None Typical Low $323.59 Median $660.69 Typical High $1,230.27 | Facility | None | $323.59 | $660.69 | $1,230.27 |
Emblem Health Setting Professional Modifier None Typical Low $151.36 Median $302.00 Typical High $549.54 | Professional | None | $151.36 | $302.00 | $549.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $134.90 Median $269.15 Typical High $478.63 | Professional | None | $134.90 | $269.15 | $478.63 |
MVP Health Care Setting Facility Modifier None Typical Low $275.42 Median $26,302.68 Typical High $38,018.94 | Facility | None | $275.42 | $26,302.68 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,388.44 Typical High $9,772.37 | Facility | None | $1,202.26 | $3,388.44 | $9,772.37 |
United Setting Professional Modifier None Typical Low $177.83 Median $295.12 Typical High $691.83 | Professional | None | $177.83 | $295.12 | $691.83 |
Univera Setting Facility Modifier None Typical Low $151.36 Median $158.49 Typical High $2,041.74 | Facility | None | $151.36 | $158.49 | $2,041.74 |
Univera Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $478.63 | Professional | None | $151.36 | $239.88 | $478.63 |
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 $338.84 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $138.04 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $512.86 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $102.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $69.18 | $70.79 | $70.79 |
Where New York sits
The same service costs 10.0 times more in Alaska 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· 16th of 51
$813
AK $2,455KY $245
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.