How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,549 to $11,749Professionalmedian $2,239 · 10th to 90th $1,778 to $3,802
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 $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $1,905.46 Median $2,238.72 Typical High $2,951.21 | Professional | None | $1,905.46 | $2,238.72 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,412.54 Typical High $1,862.09 | Professional | 62 · Two surgeons | $1,202.26 | $1,412.54 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $354.81 Typical High $478.63 | Professional | 80 · Assistant surgeon | $302.00 | $354.81 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $316.23 Typical High $416.87 | Professional | AS · PA/NP assist | $269.15 | $316.23 | $416.87 |
CDPHP Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $9,772.37 | Professional | None | $3,235.94 | $3,235.94 | $9,772.37 |
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 $2,238.72 Median $2,238.72 Typical High $5,128.61 | Professional | None | $2,238.72 | $2,238.72 | $5,128.61 |
Emblem Health Setting Facility Modifier None Typical Low $2,398.83 Median $3,548.13 Typical High $7,762.47 | Facility | None | $2,398.83 | $3,548.13 | $7,762.47 |
Emblem Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,981.07 | Professional | None | $2,398.83 | $2,398.83 | $3,981.07 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,905.46 | $3,019.95 |
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 $2,398.83 Median $3,235.94 Typical High $5,888.44 | Professional | None | $2,398.83 | $3,235.94 | $5,888.44 |
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 $1,445.44 Median $2,344.23 Typical High $5,495.41 | Professional | None | $1,445.44 | $2,344.23 | $5,495.41 |
Univera Setting Facility Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $9,549.93 | Facility | None | $1,513.56 | $1,698.24 | $9,549.93 |
Univera Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,905.46 | $3,019.95 |
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 $1,174.90 Median $1,174.90 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $478.63 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $363.08 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,659.59 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,513.56 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,023.29 | $1,513.56 | $2,511.89 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $398.11 Typical High $676.08 | Professional | 55 · Aftercare only | $269.15 | $398.11 | $676.08 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $190.55 Typical High $323.59 | Professional | 56 · Pre-op care only | $128.82 | $190.55 | $323.59 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,318.26 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $891.25 | $1,318.26 | $2,238.72 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,202.26 Median $1,230.27 Typical High $1,819.70 | Professional | 53 · Discontinued | $1,202.26 | $1,230.27 | $1,819.70 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,513.56 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,023.29 | $1,513.56 | $2,344.23 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $398.11 Typical High $1,202.26 | Professional | 55 · Aftercare only | $269.15 | $398.11 | $1,202.26 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $190.55 Typical High $575.44 | Professional | 56 · Pre-op care only | $128.82 | $190.55 | $575.44 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,318.26 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $891.25 | $1,318.26 | $2,089.30 |
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· 44th of 51
$2,239
AK $9,333TX $427
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.