How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,622 to $11,749Professionalmedian $2,512 · 10th to 90th $1,995 to $4,169
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 $2,238.72 Median $6,025.60 Typical High $10,964.78 | Facility | None | $2,238.72 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,884.03 | Professional | None | $2,570.40 | $2,570.40 | $2,884.03 |
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 $2,137.96 Median $2,511.89 Typical High $3,311.31 | Professional | None | $2,137.96 | $2,511.89 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,584.89 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,348.96 | $1,584.89 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $398.11 Typical High $524.81 | Professional | 80 · Assistant surgeon | $338.84 | $398.11 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $346.74 Typical High $457.09 | Professional | AS · PA/NP assist | $295.12 | $346.74 | $457.09 |
CDPHP Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
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 $2,454.71 Median $2,454.71 Typical High $5,754.40 | Professional | None | $2,454.71 | $2,454.71 | $5,754.40 |
Emblem Health Setting Facility Modifier None Typical Low $2,570.40 Median $4,168.69 Typical High $8,511.38 | Facility | None | $2,570.40 | $4,168.69 | $8,511.38 |
Emblem Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $4,365.16 | Professional | None | $2,238.72 | $2,238.72 | $4,365.16 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,445.44 | $2,137.96 | $3,388.44 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,786.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,691.53 Median $3,801.89 Typical High $6,456.54 | Professional | None | $2,691.53 | $3,801.89 | $6,456.54 |
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 $1,548.82 Median $2,570.40 Typical High $6,165.95 | Professional | None | $1,548.82 | $2,570.40 | $6,165.95 |
Univera Setting Facility Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $12,589.25 | Facility | None | $1,698.24 | $1,905.46 | $12,589.25 |
Univera Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,698.24 | $2,137.96 | $3,388.44 |
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 $1,258.93 Median $1,258.93 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $575.44 | Professional | 53 · Discontinued | $512.86 | $512.86 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $436.52 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $288.40 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $2,041.74 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,659.59 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,148.15 | $1,659.59 | $2,691.53 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $446.68 Typical High $707.95 | Professional | 55 · Aftercare only | $309.03 | $446.68 | $707.95 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $213.80 Typical High $338.84 | Professional | 56 · Pre-op care only | $144.54 | $213.80 | $338.84 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,479.11 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,479.11 | $2,344.23 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,348.96 Median $1,380.38 Typical High $1,949.84 | Professional | 53 · Discontinued | $1,348.96 | $1,380.38 | $1,949.84 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,659.59 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,148.15 | $1,659.59 | $2,691.53 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $446.68 Typical High $1,412.54 | Professional | 55 · Aftercare only | $309.03 | $446.68 | $1,412.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $213.80 Typical High $660.69 | Professional | 56 · Pre-op care only | $144.54 | $213.80 | $660.69 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,479.11 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,479.11 | $2,344.23 |
Where New York sits
The same service costs 20.9 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
$2,512
AK $10,471TX $501
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.