How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,445 to $13,804Professionalmedian $1,318 · 10th to 90th $1,047 to $2,138
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 $5,754.40 Typical High $10,715.19 | Facility | None | $1,819.70 | $5,754.40 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,380.38 | $1,380.38 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,456.54 Typical High $15,848.93 | Facility | None | $1,659.59 | $6,456.54 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,318.26 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $831.76 Typical High $1,122.02 | Professional | 62 · Two surgeons | $691.83 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $208.93 Typical High $288.40 | Professional | 80 · Assistant surgeon | $177.83 | $208.93 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $181.97 Typical High $251.19 | Professional | AS · PA/NP assist | $154.88 | $181.97 | $251.19 |
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 $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,737.80 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,951.21 | Professional | None | $1,230.27 | $1,230.27 | $2,951.21 |
Emblem Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $4,677.35 | Facility | None | $1,348.96 | $1,737.80 | $4,677.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,445.44 | $2,187.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,737.80 | Professional | None | $758.58 | $1,148.15 | $1,737.80 |
Highmark BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Facility | None | $6,918.31 | $6,918.31 | $6,918.31 |
MVP Health Care Setting Facility Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,380.38 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $3,311.31 | Professional | None | $1,380.38 | $1,621.81 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $3,090.30 | Professional | None | $851.14 | $1,288.25 | $3,090.30 |
Univera Setting Facility Modifier None Typical Low $891.25 Median $1,202.26 Typical High $5,370.32 | Facility | None | $891.25 | $1,202.26 | $5,370.32 |
Univera Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,737.80 | Professional | None | $891.25 | $1,148.15 | $1,737.80 |
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 $691.83 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $691.83 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $281.84 | Professional | 53 · Discontinued | $275.42 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $977.24 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $912.01 Typical High $1,479.11 | Professional | 54 · Surgery only | $602.56 | $912.01 | $1,479.11 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $245.47 Typical High $389.05 | Professional | 55 · Aftercare only | $158.49 | $245.47 | $389.05 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $114.82 Typical High $186.21 | Professional | 56 · Pre-op care only | $75.86 | $114.82 | $186.21 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $794.33 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $524.81 | $794.33 | $1,288.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $724.44 Typical High $1,023.29 | Professional | 53 · Discontinued | $691.83 | $724.44 | $1,023.29 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $912.01 Typical High $1,380.38 | Professional | 54 · Surgery only | $602.56 | $912.01 | $1,380.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $245.47 Typical High $707.95 | Professional | 55 · Aftercare only | $158.49 | $245.47 | $707.95 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $114.82 Typical High $338.84 | Professional | 56 · Pre-op care only | $75.86 | $114.82 | $338.84 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $794.33 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $524.81 | $794.33 | $1,202.26 |
Where New York sits
The same service costs 15.1 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
$1,318
AK $5,370TX $355
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.