How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,072 to $7,762Professionalmedian $832 · 10th to 90th $631 to $1,549
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,148.15 | Professional | None | $776.25 | $776.25 | $1,148.15 |
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 $691.83 Median $831.76 Typical High $1,513.56 | Professional | None | $691.83 | $831.76 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $524.81 Typical High $954.99 | Professional | 62 · Two surgeons | $446.68 | $524.81 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $239.88 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $117.49 Typical High $208.93 | Professional | AS · PA/NP assist | $97.72 | $117.49 | $208.93 |
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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $3,890.45 | Facility | None | $1,348.96 | $1,905.46 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $1,122.02 Typical High $1,659.59 | Professional | None | $588.84 | $1,122.02 | $1,659.59 |
Emblem Health Setting Facility Modifier None Typical Low $676.08 Median $1,023.29 Typical High $3,235.94 | Facility | None | $676.08 | $1,023.29 | $3,235.94 |
Emblem Health Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,698.24 | Professional | None | $891.25 | $1,000.00 | $1,698.24 |
Excellus BCBS Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,071.52 | Professional | None | $616.60 | $758.58 | $1,071.52 |
MVP Health Care Setting Facility Modifier None Typical Low $851.14 Median $4,786.30 Typical High $5,754.40 | Facility | None | $851.14 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,621.81 | Professional | None | $1,023.29 | $1,023.29 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,754.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $524.81 Median $851.14 Typical High $1,548.82 | Professional | None | $524.81 | $851.14 | $1,548.82 |
Univera Setting Facility Modifier None Typical Low $676.08 Median $831.76 Typical High $2,951.21 | Facility | None | $676.08 | $831.76 | $2,951.21 |
Univera Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,071.52 | Professional | None | $616.60 | $794.33 | $1,071.52 |
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 $389.05 Median $389.05 Typical High $467.74 | Professional | 52 · Reduced service | $389.05 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $186.21 | Professional | 53 · Discontinued | $154.88 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $707.95 | Professional | 54 · Surgery only | $588.84 | $588.84 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $141.25 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $93.33 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $660.69 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $645.65 Typical High $870.96 | Professional | 54 · Surgery only | $501.19 | $645.65 | $870.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $151.36 Typical High $204.17 | Professional | 55 · Aftercare only | $117.49 | $151.36 | $204.17 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $79.43 Typical High $107.15 | Professional | 56 · Pre-op care only | $61.66 | $79.43 | $107.15 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $562.34 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $436.52 | $562.34 | $758.58 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $602.56 Typical High $707.95 | Professional | 53 · Discontinued | $478.63 | $602.56 | $707.95 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $645.65 Typical High $870.96 | Professional | 54 · Surgery only | $501.19 | $645.65 | $870.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $151.36 Typical High $229.09 | Professional | 55 · Aftercare only | $117.49 | $151.36 | $229.09 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $79.43 Typical High $120.23 | Professional | 56 · Pre-op care only | $61.66 | $79.43 | $120.23 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $562.34 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $436.52 | $562.34 | $831.76 |
Where New York sits
The same service costs 7.6 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· 45th of 51
$891
AK $3,715TX $490
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.