How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,514 to $11,749Professionalmedian $1,698 · 10th to 90th $1,413 to $2,951
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 $2,041.74 Median $6,309.57 Typical High $12,589.25 | Facility | None | $2,041.74 | $6,309.57 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,621.81 | $1,621.81 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,445.44 | $1,698.24 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,071.52 Typical High $1,445.44 | Professional | 62 · Two surgeons | $912.01 | $1,071.52 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $275.42 Typical High $371.54 | Professional | 80 · Assistant surgeon | $234.42 | $275.42 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $239.88 Typical High $323.59 | Professional | AS · PA/NP assist | $204.17 | $239.88 | $323.59 |
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 $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,737.80 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $3,981.07 | Professional | None | $1,905.46 | $1,905.46 | $3,981.07 |
Emblem Health Setting Facility Modifier None Typical Low $1,819.70 Median $2,290.87 Typical High $7,079.46 | Facility | None | $1,819.70 | $2,290.87 | $7,079.46 |
Emblem Health Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $3,311.31 | Professional | None | $1,698.24 | $2,137.96 | $3,311.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,659.59 Typical High $2,951.21 | Professional | None | $831.76 | $1,659.59 | $2,951.21 |
MVP Health Care Setting Facility Modifier None Typical Low $1,479.11 Median $5,754.40 Typical High $38,018.94 | Facility | None | $1,479.11 | $5,754.40 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $4,570.88 | Professional | None | $1,819.70 | $1,995.26 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $14,791.08 | Facility | None | $1,318.26 | $4,168.69 | $14,791.08 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $4,265.80 | Professional | None | $1,174.90 | $1,905.46 | $4,265.80 |
Univera Setting Facility Modifier None Typical Low $977.24 Median $1,698.24 Typical High $5,754.40 | Facility | None | $977.24 | $1,698.24 | $5,754.40 |
Univera Setting Professional Modifier None Typical Low $977.24 Median $1,659.59 Typical High $2,951.21 | Professional | None | $977.24 | $1,659.59 | $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 $812.83 Median $812.83 Typical High $891.25 | Professional | 52 · Reduced service | $812.83 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $363.08 | Professional | 53 · Discontinued | $323.59 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $269.15 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $181.97 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,258.93 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,288.25 Typical High $2,344.23 | Professional | 54 · Surgery only | $660.69 | $1,288.25 | $2,344.23 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $346.74 Typical High $616.60 | Professional | 55 · Aftercare only | $173.78 | $346.74 | $616.60 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $165.96 Typical High $295.12 | Professional | 56 · Pre-op care only | $83.18 | $165.96 | $295.12 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $1,122.02 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $575.44 | $1,122.02 | $2,041.74 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $912.01 Typical High $1,380.38 | Professional | 53 · Discontinued | $912.01 | $912.01 | $1,380.38 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,288.25 Typical High $2,344.23 | Professional | 54 · Surgery only | $660.69 | $1,288.25 | $2,344.23 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $346.74 Typical High $933.25 | Professional | 55 · Aftercare only | $173.78 | $346.74 | $933.25 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $165.96 Typical High $436.52 | Professional | 56 · Pre-op care only | $83.18 | $165.96 | $436.52 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $1,122.02 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $575.44 | $1,122.02 | $2,041.74 |
Where New York sits
The same service costs 11.2 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· 43rd of 51
$1,698
AK $7,244TX $646
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.