How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,479 to $11,482Professionalmedian $1,318 · 10th to 90th $1,047 to $2,239
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 $1,905.46 Median $6,165.95 Typical High $11,748.98 | Facility | None | $1,905.46 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,412.54 | $1,659.59 |
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 $1,122.02 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,122.02 | $1,318.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $831.76 Typical High $1,148.15 | Professional | 62 · Two surgeons | $707.95 | $831.76 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $208.93 Typical High $288.40 | Professional | 80 · Assistant surgeon | $177.83 | $208.93 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $186.21 Typical High $257.04 | Professional | AS · PA/NP assist | $154.88 | $186.21 | $257.04 |
CDPHP Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
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 $1,318.26 Median $1,318.26 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,318.26 | $3,090.30 |
Emblem Health Setting Facility Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $4,677.35 | Facility | None | $1,348.96 | $1,905.46 | $4,677.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,445.44 | $2,290.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,174.90 Typical High $1,819.70 | Professional | None | $794.33 | $1,174.90 | $1,819.70 |
MVP Health Care Setting Facility Modifier None Typical Low $1,548.82 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,548.82 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $3,467.37 | Professional | None | $1,258.93 | $1,258.93 | $3,467.37 |
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 $851.14 Median $1,380.38 Typical High $3,311.31 | Professional | None | $851.14 | $1,380.38 | $3,311.31 |
Univera Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $5,495.41 | Facility | None | $933.25 | $1,258.93 | $5,495.41 |
Univera Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,819.70 | Professional | None | $933.25 | $1,174.90 | $1,819.70 |
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 $707.95 Median $707.95 Typical High $758.58 | Professional | 52 · Reduced service | $707.95 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $302.00 | Professional | 53 · Discontinued | $281.84 | $281.84 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $229.09 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $151.36 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,071.52 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $912.01 Typical High $1,445.44 | Professional | 54 · Surgery only | $616.60 | $912.01 | $1,445.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $245.47 Typical High $380.19 | Professional | 55 · Aftercare only | $165.96 | $245.47 | $380.19 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $117.49 Typical High $181.97 | Professional | 56 · Pre-op care only | $79.43 | $117.49 | $181.97 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $812.83 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $549.54 | $812.83 | $1,258.93 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $741.31 Typical High $1,047.13 | Professional | 53 · Discontinued | $707.95 | $741.31 | $1,047.13 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $912.01 Typical High $1,445.44 | Professional | 54 · Surgery only | $616.60 | $912.01 | $1,445.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $245.47 Typical High $758.58 | Professional | 55 · Aftercare only | $165.96 | $245.47 | $758.58 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $117.49 Typical High $363.08 | Professional | 56 · Pre-op care only | $79.43 | $117.49 | $363.08 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $812.83 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $549.54 | $812.83 | $1,258.93 |
Where New York sits
The same service costs 9.1 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· 46th of 51
$1,318
AK $5,623TX $617
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.