How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,230 to $8,128Professionalmedian $2,512 · 10th to 90th $1,905 to $4,571
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 $2,137.96 Median $6,165.95 Typical High $10,964.78 | Facility | None | $2,137.96 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $7,079.46 | Professional | None | $2,290.87 | $2,290.87 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $4,570.88 | Professional | None | $2,089.30 | $2,511.89 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,584.89 Typical High $2,884.03 | Professional | 62 · Two surgeons | $1,348.96 | $1,584.89 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $407.38 Typical High $724.44 | Professional | 80 · Assistant surgeon | $338.84 | $407.38 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $354.81 Typical High $645.65 | Professional | AS · PA/NP assist | $302.00 | $354.81 | $645.65 |
CDPHP Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $10,964.78 | Facility | None | $3,630.78 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,949.84 Typical High $3,981.07 | Facility | None | $1,380.38 | $1,949.84 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $3,311.31 Typical High $4,570.88 | Professional | None | $1,737.80 | $3,311.31 | $4,570.88 |
Emblem Health Setting Facility Modifier None Typical Low $2,041.74 Median $2,884.03 Typical High $9,120.11 | Facility | None | $2,041.74 | $2,884.03 | $9,120.11 |
Emblem Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $4,897.79 | Professional | None | $2,570.40 | $2,818.38 | $4,897.79 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,238.72 | $3,162.28 |
MVP Health Care Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,691.53 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $4,786.30 | Professional | None | $3,388.44 | $3,388.44 | $4,786.30 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,309.57 | Facility | None | $831.76 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $2,511.89 Typical High $4,570.88 | Professional | None | $1,548.82 | $2,511.89 | $4,570.88 |
Univera Setting Facility Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $9,332.54 | Facility | None | $1,995.26 | $2,454.71 | $9,332.54 |
Univera Setting Professional Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,238.72 | $3,162.28 |
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 $1,148.15 Median $1,148.15 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $549.54 | Professional | 53 · Discontinued | $457.09 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $416.87 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $275.42 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,905.46 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,819.70 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,479.11 | $1,819.70 | $2,570.40 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $426.58 Typical High $602.56 | Professional | 55 · Aftercare only | $346.74 | $426.58 | $602.56 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $223.87 Typical High $316.23 | Professional | 56 · Pre-op care only | $181.97 | $223.87 | $316.23 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,584.89 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,584.89 | $2,238.72 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,412.54 Median $1,819.70 Typical High $2,238.72 | Professional | 53 · Discontinued | $1,412.54 | $1,819.70 | $2,238.72 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,819.70 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,479.11 | $1,819.70 | $2,570.40 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $426.58 Typical High $676.08 | Professional | 55 · Aftercare only | $346.74 | $426.58 | $676.08 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $223.87 Typical High $354.81 | Professional | 56 · Pre-op care only | $181.97 | $223.87 | $354.81 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,584.89 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,584.89 | $2,454.71 |
Where New York sits
The same service costs 15.8 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· 39th of 51
$2,512
AK $8,128TX $513
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.