How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,549 to $11,749Professionalmedian $1,905 · 10th to 90th $1,514 to $3,162
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 $2,089.30 Median $6,025.60 Typical High $10,964.78 | Facility | None | $2,089.30 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,041.74 | $2,137.96 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,584.89 | $1,905.46 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,174.90 Typical High $1,621.81 | Professional | 62 · Two surgeons | $1,000.00 | $1,174.90 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $302.00 Typical High $416.87 | Professional | 80 · Assistant surgeon | $257.04 | $302.00 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $263.03 Typical High $363.08 | Professional | AS · PA/NP assist | $223.87 | $263.03 | $363.08 |
CDPHP Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,737.80 | $6,309.57 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $4,365.16 | Professional | None | $1,862.09 | $1,862.09 | $4,365.16 |
Emblem Health Setting Facility Modifier None Typical Low $1,949.84 Median $3,090.30 Typical High $6,456.54 | Facility | None | $1,949.84 | $3,090.30 | $6,456.54 |
Emblem Health Setting Professional Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,778.28 | $1,995.26 | $3,235.94 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,096.48 | $1,621.81 | $2,511.89 |
MVP Health Care Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,137.96 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,041.74 Median $2,818.38 Typical High $4,897.79 | Professional | None | $2,041.74 | $2,818.38 | $4,897.79 |
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 $1,174.90 Median $1,949.84 Typical High $4,570.88 | Professional | None | $1,174.90 | $1,949.84 | $4,570.88 |
Univera Setting Facility Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $8,912.51 | Facility | None | $1,288.25 | $1,778.28 | $8,912.51 |
Univera Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,621.81 | $2,511.89 |
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 $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,023.29 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $407.38 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,513.56 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $302.00 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $204.17 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,513.56 | $1,513.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,258.93 Typical High $2,137.96 | Professional | 54 · Surgery only | $870.96 | $1,258.93 | $2,137.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $338.84 Typical High $575.44 | Professional | 55 · Aftercare only | $229.09 | $338.84 | $575.44 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $162.18 Typical High $269.15 | Professional | 56 · Pre-op care only | $109.65 | $162.18 | $269.15 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,096.48 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $758.58 | $1,096.48 | $1,862.09 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $1,047.13 Typical High $1,479.11 | Professional | 53 · Discontinued | $1,000.00 | $1,047.13 | $1,479.11 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,288.25 Typical High $1,995.26 | Professional | 54 · Surgery only | $870.96 | $1,288.25 | $1,995.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $338.84 Typical High $1,023.29 | Professional | 55 · Aftercare only | $229.09 | $338.84 | $1,023.29 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $162.18 Typical High $489.78 | Professional | 56 · Pre-op care only | $109.65 | $162.18 | $489.78 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,122.02 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $758.58 | $1,122.02 | $1,778.28 |
Where New York sits
The same service costs 21.9 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
$1,905
AK $7,943TX $363
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.