How much rates vary
Facilitymedian $6,918 · 10th to 90th $1,698 to $15,849Professionalmedian $2,291 · 10th to 90th $1,820 to $3,981
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 $2,089.30 Median $6,456.54 Typical High $12,882.50 | Facility | None | $2,089.30 | $6,456.54 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,344.23 | Professional | None | $2,089.30 | $2,089.30 | $2,344.23 |
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 $1,949.84 Median $2,290.87 Typical High $3,162.28 | Professional | None | $1,949.84 | $2,290.87 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,445.44 Typical High $1,949.84 | Professional | 62 · Two surgeons | $1,230.27 | $1,445.44 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $363.08 Typical High $501.19 | Professional | 80 · Assistant surgeon | $309.03 | $363.08 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $316.23 Typical High $436.52 | Professional | AS · PA/NP assist | $269.15 | $316.23 | $436.52 |
CDPHP Setting Facility Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $13,489.63 | Facility | None | $3,388.44 | $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 $18,620.87 Typical High $38,018.94 | Facility | None | $1,737.80 | $18,620.87 | $38,018.94 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $5,248.07 | Professional | None | $2,511.89 | $2,511.89 | $5,248.07 |
Emblem Health Setting Facility Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $9,120.11 | Facility | None | $2,454.71 | $2,884.03 | $9,120.11 |
Emblem Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $4,466.84 | Professional | None | $2,238.72 | $2,691.53 | $4,466.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $3,801.89 | Professional | None | $1,071.52 | $2,089.30 | $3,801.89 |
MVP Health Care Setting Facility Modifier None Typical Low $2,089.30 Median $5,754.40 Typical High $38,018.94 | Facility | None | $2,089.30 | $5,754.40 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $4,897.79 | Professional | None | $1,905.46 | $1,905.46 | $4,897.79 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,677.35 Typical High $16,982.44 | Facility | None | $1,380.38 | $4,677.35 | $16,982.44 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,570.40 Typical High $5,623.41 | Professional | None | $1,584.89 | $2,570.40 | $5,623.41 |
Univera Setting Facility Modifier None Typical Low $1,258.93 Median $2,238.72 Typical High $6,025.60 | Facility | None | $1,258.93 | $2,238.72 | $6,025.60 |
Univera Setting Professional Modifier None Typical Low $1,258.93 Median $2,089.30 Typical High $3,801.89 | Professional | None | $1,258.93 | $2,089.30 | $3,801.89 |
10 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 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,778.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,659.59 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,659.59 Typical High $3,019.95 | Professional | 54 · Surgery only | $851.14 | $1,659.59 | $3,019.95 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $436.52 Typical High $812.83 | Professional | 55 · Aftercare only | $229.09 | $436.52 | $812.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $208.93 Typical High $380.19 | Professional | 56 · Pre-op care only | $107.15 | $208.93 | $380.19 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,445.44 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $741.31 | $1,445.44 | $2,630.27 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,659.59 Typical High $3,019.95 | Professional | 54 · Surgery only | $851.14 | $1,659.59 | $3,019.95 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $436.52 Typical High $1,202.26 | Professional | 55 · Aftercare only | $229.09 | $436.52 | $1,202.26 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $208.93 Typical High $575.44 | Professional | 56 · Pre-op care only | $107.15 | $208.93 | $575.44 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,445.44 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $741.31 | $1,445.44 | $2,630.27 |
Where New York sits
The same service costs 8.1 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· 42nd of 51
$2,291
AK $9,550TX $1,175
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.