How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,413 to $10,233Professionalmedian $1,660 · 10th to 90th $1,230 to $3,020
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $4,168.69 | Professional | None | $1,412.54 | $1,412.54 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,951.21 | Professional | None | $1,380.38 | $1,659.59 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,047.13 Typical High $1,862.09 | Professional | 62 · Two surgeons | $870.96 | $1,047.13 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $263.03 Typical High $467.74 | Professional | 80 · Assistant surgeon | $218.78 | $263.03 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $229.09 Typical High $416.87 | Professional | AS · PA/NP assist | $194.98 | $229.09 | $416.87 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $3,235.94 Typical High $6,606.93 | Facility | None | $1,513.56 | $3,235.94 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,148.15 | $2,187.76 | $3,019.95 |
Emblem Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,905.46 Typical High $6,165.95 | Facility | None | $1,258.93 | $1,905.46 | $6,165.95 |
Emblem Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $3,235.94 | Professional | None | $1,698.24 | $1,862.09 | $3,235.94 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,513.56 | $2,089.30 |
MVP Health Care Setting Facility Modifier None Typical Low $1,698.24 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,698.24 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,090.30 | Professional | None | $2,137.96 | $2,137.96 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $3,019.95 | Professional | None | $1,023.29 | $1,659.59 | $3,019.95 |
Univera Setting Facility Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $5,754.40 | Facility | None | $1,318.26 | $1,621.81 | $5,754.40 |
Univera Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,513.56 | $2,089.30 |
15 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 $707.95 Median $707.95 Typical High $912.01 | Professional | 52 · Reduced service | $707.95 | $707.95 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $363.08 | Professional | 53 · Discontinued | $281.84 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $269.15 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $181.97 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,258.93 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,230.27 Typical High $1,698.24 | Professional | 54 · Surgery only | $977.24 | $1,230.27 | $1,698.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $288.40 Typical High $398.11 | Professional | 55 · Aftercare only | $229.09 | $288.40 | $398.11 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $151.36 Typical High $208.93 | Professional | 56 · Pre-op care only | $120.23 | $151.36 | $208.93 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,071.52 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $851.14 | $1,071.52 | $1,479.11 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $1,174.90 Typical High $1,380.38 | Professional | 53 · Discontinued | $933.25 | $1,174.90 | $1,380.38 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,230.27 Typical High $1,698.24 | Professional | 54 · Surgery only | $977.24 | $1,230.27 | $1,698.24 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $288.40 Typical High $446.68 | Professional | 55 · Aftercare only | $229.09 | $288.40 | $446.68 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $151.36 Typical High $234.42 | Professional | 56 · Pre-op care only | $120.23 | $151.36 | $234.42 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,071.52 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $851.14 | $1,071.52 | $1,621.81 |
Where New York sits
The same service costs 8.7 times more in Alaska than in Texas. 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· 43rd of 51
$1,698
AK $7,244TX $832
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.