How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,549 to $11,482Professionalmedian $2,188 · 10th to 90th $1,778 to $3,548
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 $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,344.23 | Professional | None | $1,995.26 | $1,995.26 | $2,344.23 |
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 $2,884.03 | Professional | None | $1,905.46 | $2,238.72 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,412.54 Typical High $1,737.80 | Professional | 62 · Two surgeons | $1,202.26 | $1,412.54 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $354.81 Typical High $446.68 | Professional | 80 · Assistant surgeon | $302.00 | $354.81 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $309.03 Typical High $389.05 | Professional | AS · PA/NP assist | $263.03 | $309.03 | $389.05 |
CDPHP Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $13,489.63 | Facility | None | $4,466.84 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
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 $2,187.76 Median $2,187.76 Typical High $4,786.30 | Professional | None | $2,187.76 | $2,187.76 | $4,786.30 |
Emblem Health Setting Facility Modifier None Typical Low $1,659.59 Median $2,454.71 Typical High $7,762.47 | Facility | None | $1,659.59 | $2,454.71 | $7,762.47 |
Emblem Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $3,801.89 | Professional | None | $2,041.74 | $2,041.74 | $3,801.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,258.93 | $1,905.46 | $2,951.21 |
MVP Health Care Setting Facility Modifier None Typical Low $1,995.26 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,995.26 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,398.83 Median $2,570.40 Typical High $4,677.35 | Professional | None | $2,398.83 | $2,570.40 | $4,677.35 |
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 $2,290.87 Typical High $5,128.61 | Professional | None | $1,445.44 | $2,290.87 | $5,128.61 |
Univera Setting Facility Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $8,709.64 | Facility | None | $1,479.11 | $2,041.74 | $8,709.64 |
Univera Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,905.46 | $2,951.21 |
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 $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $467.74 | Professional | 53 · Discontinued | $398.11 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $234.42 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,621.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,513.56 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,000.00 | $1,513.56 | $2,454.71 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $407.38 Typical High $660.69 | Professional | 55 · Aftercare only | $263.03 | $407.38 | $660.69 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $190.55 Typical High $316.23 | Professional | 56 · Pre-op care only | $125.89 | $190.55 | $316.23 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,318.26 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $870.96 | $1,318.26 | $2,137.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,174.90 Median $1,202.26 Typical High $1,778.28 | Professional | 53 · Discontinued | $1,174.90 | $1,202.26 | $1,778.28 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,513.56 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,000.00 | $1,513.56 | $2,290.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $407.38 Typical High $1,174.90 | Professional | 55 · Aftercare only | $263.03 | $407.38 | $1,174.90 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $190.55 Typical High $562.34 | Professional | 56 · Pre-op care only | $125.89 | $190.55 | $562.34 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,318.26 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $870.96 | $1,318.26 | $2,041.74 |
Where New York sits
The same service costs 21.4 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· 40th of 51
$2,239
AK $9,120TX $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.