How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,585 to $13,183Professionalmedian $1,950 · 10th to 90th $1,549 to $3,388
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 $2,290.87 Median $6,456.54 Typical High $12,882.50 | Facility | None | $2,290.87 | $6,456.54 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,995.26 | $2,187.76 | $2,187.76 |
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 $1,621.81 Median $1,905.46 Typical High $2,818.38 | Professional | None | $1,621.81 | $1,905.46 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,202.26 Typical High $1,778.28 | Professional | 62 · Two surgeons | $1,023.29 | $1,202.26 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $309.03 Typical High $457.09 | Professional | 80 · Assistant surgeon | $263.03 | $309.03 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $269.15 Typical High $398.11 | Professional | AS · PA/NP assist | $229.09 | $269.15 | $398.11 |
CDPHP Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $15,135.61 Typical High $30,902.95 | Facility | None | $1,737.80 | $15,135.61 | $30,902.95 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $4,570.88 | Professional | None | $2,137.96 | $2,137.96 | $4,570.88 |
Emblem Health Setting Facility Modifier None Typical Low $2,137.96 Median $2,754.23 Typical High $7,762.47 | Facility | None | $2,137.96 | $2,754.23 | $7,762.47 |
Emblem Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $3,715.35 | Professional | None | $1,862.09 | $2,344.23 | $3,715.35 |
Excellus BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,778.28 Typical High $3,235.94 | Professional | None | $912.01 | $1,778.28 | $3,235.94 |
MVP Health Care Setting Facility Modifier None Typical Low $1,905.46 Median $5,754.40 Typical High $38,018.94 | Facility | None | $1,905.46 | $5,754.40 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $2,041.74 Median $2,630.27 Typical High $5,248.07 | Professional | None | $2,041.74 | $2,630.27 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,677.35 Typical High $15,848.93 | Facility | None | $1,380.38 | $4,677.35 | $15,848.93 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $2,137.96 Typical High $5,011.87 | Professional | None | $1,380.38 | $2,137.96 | $5,011.87 |
Univera Setting Facility Modifier None Typical Low $1,071.52 Median $1,862.09 Typical High $8,128.31 | Facility | None | $1,071.52 | $1,862.09 | $8,128.31 |
Univera Setting Professional Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,235.94 | Professional | None | $1,071.52 | $1,778.28 | $3,235.94 |
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 $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,000.00 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $398.11 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,513.56 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $302.00 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $199.53 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,513.56 | $1,513.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,412.54 Typical High $2,570.40 | Professional | 54 · Surgery only | $724.44 | $1,412.54 | $2,570.40 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $380.19 Typical High $691.83 | Professional | 55 · Aftercare only | $194.98 | $380.19 | $691.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $177.83 Typical High $323.59 | Professional | 56 · Pre-op care only | $91.20 | $177.83 | $323.59 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,230.27 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $630.96 | $1,230.27 | $2,238.72 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,023.29 Median $1,023.29 Typical High $1,513.56 | Professional | 53 · Discontinued | $1,023.29 | $1,023.29 | $1,513.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,412.54 Typical High $2,570.40 | Professional | 54 · Surgery only | $724.44 | $1,412.54 | $2,570.40 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $380.19 Typical High $1,047.13 | Professional | 55 · Aftercare only | $194.98 | $380.19 | $1,047.13 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $177.83 Typical High $501.19 | Professional | 56 · Pre-op care only | $91.20 | $177.83 | $501.19 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,230.27 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $630.96 | $1,230.27 | $2,238.72 |
Where New York sits
The same service costs 16.2 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· 44th of 51
$1,995
AK $8,128TX $501
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.