How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,698 to $15,488Professionalmedian $2,089 · 10th to 90th $1,698 to $3,631
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 $2,238.72 Median $2,238.72 Typical High $2,290.87 | Professional | None | $2,238.72 | $2,238.72 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,778.28 | $2,089.30 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,318.26 Typical High $1,862.09 | Professional | 62 · Two surgeons | $1,122.02 | $1,318.26 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $338.84 Typical High $467.74 | Professional | 80 · Assistant surgeon | $288.40 | $338.84 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $295.12 Typical High $407.38 | Professional | AS · PA/NP assist | $251.19 | $295.12 | $407.38 |
CDPHP Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $14,791.08 Typical High $30,199.52 | Facility | None | $1,737.80 | $14,791.08 | $30,199.52 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $5,011.87 | Professional | None | $2,137.96 | $2,137.96 | $5,011.87 |
Emblem Health Setting Facility Modifier None Typical Low $2,290.87 Median $3,162.28 Typical High $7,413.10 | Facility | None | $2,290.87 | $3,162.28 | $7,413.10 |
Emblem Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $3,630.78 | Professional | None | $1,995.26 | $2,290.87 | $3,630.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $3,630.78 | Professional | None | $1,023.29 | $1,819.70 | $3,630.78 |
MVP Health Care Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $38,018.94 | Facility | None | $2,290.87 | $5,754.40 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $2,238.72 Median $3,019.95 Typical High $5,495.41 | Professional | None | $2,238.72 | $3,019.95 | $5,495.41 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $16,982.44 | Facility | None | $1,380.38 | $4,786.30 | $16,982.44 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $2,238.72 Typical High $5,128.61 | Professional | None | $1,380.38 | $2,238.72 | $5,128.61 |
Univera Setting Facility Modifier None Typical Low $1,202.26 Median $1,995.26 Typical High $9,332.54 | Facility | None | $1,202.26 | $1,995.26 | $9,332.54 |
Univera Setting Professional Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $3,630.78 | Professional | None | $1,202.26 | $1,819.70 | $3,630.78 |
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 $1,122.02 Median $1,122.02 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $446.68 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,698.24 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,659.59 | $1,698.24 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $338.84 Typical High $346.74 | Professional | 55 · Aftercare only | $331.13 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $223.87 Typical High $229.09 | Professional | 56 · Pre-op care only | $223.87 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,584.89 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,584.89 | $1,621.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,584.89 Typical High $3,162.28 | Professional | 54 · Surgery only | $891.25 | $1,584.89 | $3,162.28 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $234.42 Typical High $467.74 | Professional | 55 · Aftercare only | $131.83 | $234.42 | $467.74 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $199.53 Typical High $398.11 | Professional | 56 · Pre-op care only | $112.20 | $199.53 | $398.11 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,380.38 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $776.25 | $1,380.38 | $2,754.23 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,122.02 Median $1,148.15 Typical High $1,698.24 | Professional | 53 · Discontinued | $1,122.02 | $1,148.15 | $1,698.24 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,584.89 Typical High $3,162.28 | Professional | 54 · Surgery only | $891.25 | $1,584.89 | $3,162.28 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $234.42 Typical High $724.44 | Professional | 55 · Aftercare only | $131.83 | $234.42 | $724.44 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $199.53 Typical High $602.56 | Professional | 56 · Pre-op care only | $112.20 | $199.53 | $602.56 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,380.38 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $776.25 | $1,380.38 | $2,754.23 |
Where New York sits
The same service costs 6.5 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
$2,138
AK $8,710TX $1,349
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.