How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,175 to $12,303Professionalmedian $776 · 10th to 90th $251 to $955
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 $645.65 Median $676.08 Typical High $676.08 | Professional | None | $645.65 | $676.08 | $676.08 |
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 $741.31 Median $851.14 Typical High $954.99 | Professional | None | $741.31 | $851.14 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,288.25 Typical High $1,445.44 | Professional | 50 · Both sides | $1,096.48 | $1,288.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $537.03 Typical High $602.56 | Professional | 62 · Two surgeons | $467.74 | $537.03 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $138.04 Typical High $154.88 | Professional | 80 · Assistant surgeon | $117.49 | $138.04 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $120.23 Typical High $134.90 | Professional | AS · PA/NP assist | $102.33 | $120.23 | $134.90 |
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 $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,884.03 Typical High $6,025.60 | Facility | None | $954.99 | $2,884.03 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $1,348.96 | Professional | None | $512.86 | $512.86 | $1,348.96 |
Emblem Health Setting Facility Modifier None Typical Low $331.13 Median $660.69 Typical High $1,318.26 | Facility | None | $331.13 | $660.69 | $1,318.26 |
Emblem Health Setting Professional Modifier None Typical Low $162.18 Median $323.59 Typical High $588.84 | Professional | None | $162.18 | $323.59 | $588.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $128.82 Median $251.19 Typical High $457.09 | Professional | None | $128.82 | $251.19 | $457.09 |
MVP Health Care Setting Facility Modifier None Typical Low $288.40 Median $26,302.68 Typical High $38,018.94 | Facility | None | $288.40 | $26,302.68 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $190.55 Median $309.03 Typical High $724.44 | Professional | None | $190.55 | $309.03 | $724.44 |
Univera Setting Facility Modifier None Typical Low $151.36 Median $162.18 Typical High $1,905.46 | Facility | None | $151.36 | $162.18 | $1,905.46 |
Univera Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $457.09 | Professional | None | $151.36 | $239.88 | $457.09 |
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 $323.59 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $323.59 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $128.82 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $489.78 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $97.72 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $67.61 |
Where New York sits
The same service costs 10.5 times more in Alaska 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· 15th of 51
$776
AK $2,344HI $224
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.