How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,445 to $11,749Professionalmedian $1,230 · 10th to 90th $977 to $1,950
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 $6,165.95 Typical High $11,748.98 | Facility | None | $1,819.70 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | None | $1,258.93 | $1,258.93 | $1,412.54 |
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 $1,047.13 Median $1,230.27 Typical High $1,548.82 | Professional | None | $1,047.13 | $1,230.27 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $776.25 Typical High $977.24 | Professional | 62 · Two surgeons | $660.69 | $776.25 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $199.53 Typical High $251.19 | Professional | 80 · Assistant surgeon | $165.96 | $199.53 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $173.78 Typical High $218.78 | Professional | AS · PA/NP assist | $147.91 | $173.78 | $218.78 |
CDPHP Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $12,302.69 | Facility | None | $4,073.80 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $1,122.02 Median $1,122.02 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,122.02 | $2,754.23 |
Emblem Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $4,265.80 | Facility | None | $1,230.27 | $1,698.24 | $4,265.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,318.26 | $1,995.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,621.81 | Professional | None | $691.83 | $1,071.52 | $1,621.81 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,288.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,090.30 | Professional | None | $1,288.25 | $1,548.82 | $3,090.30 |
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 $776.25 Median $1,202.26 Typical High $2,884.03 | Professional | None | $776.25 | $1,202.26 | $2,884.03 |
Univera Setting Facility Modifier None Typical Low $812.83 Median $1,096.48 Typical High $4,897.79 | Facility | None | $812.83 | $1,096.48 | $4,897.79 |
Univera Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,621.81 | Professional | None | $812.83 | $1,071.52 | $1,621.81 |
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 $616.60 Median $616.60 Typical High $645.65 | Professional | 52 · Reduced service | $616.60 | $616.60 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $257.04 | Professional | 53 · Discontinued | $251.19 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $977.24 | Professional | 54 · Surgery only | $933.25 | $933.25 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $194.98 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $128.82 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $912.01 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $831.76 Typical High $1,288.25 | Professional | 54 · Surgery only | $549.54 | $831.76 | $1,288.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $223.87 Typical High $338.84 | Professional | 55 · Aftercare only | $147.91 | $223.87 | $338.84 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $107.15 Typical High $162.18 | Professional | 56 · Pre-op care only | $69.18 | $107.15 | $162.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $724.44 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $478.63 | $724.44 | $1,122.02 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $676.08 Typical High $954.99 | Professional | 53 · Discontinued | $645.65 | $676.08 | $954.99 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $831.76 Typical High $1,288.25 | Professional | 54 · Surgery only | $549.54 | $831.76 | $1,288.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $223.87 Typical High $676.08 | Professional | 55 · Aftercare only | $147.91 | $223.87 | $676.08 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $107.15 Typical High $316.23 | Professional | 56 · Pre-op care only | $69.18 | $107.15 | $316.23 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $724.44 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $478.63 | $724.44 | $1,122.02 |
Where New York sits
The same service costs 14.5 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
$1,230
AK $4,898TX $339
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.