How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,698 to $14,454Professionalmedian $2,089 · 10th to 90th $1,698 to $3,890
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 $2,137.96 Median $2,137.96 Typical High $2,290.87 | Professional | None | $2,137.96 | $2,137.96 | $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 $1,698.24 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,698.24 | $1,995.26 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,258.93 Typical High $1,819.70 | Professional | 62 · Two surgeons | $1,071.52 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $316.23 Typical High $467.74 | Professional | 80 · Assistant surgeon | $269.15 | $316.23 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $275.42 Typical High $407.38 | Professional | AS · PA/NP assist | $234.42 | $275.42 | $407.38 |
CDPHP Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
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 $2,238.72 Median $2,454.71 Typical High $5,128.61 | Professional | None | $2,238.72 | $2,454.71 | $5,128.61 |
Emblem Health Setting Facility Modifier None Typical Low $2,511.89 Median $3,235.94 Typical High $8,912.51 | Facility | None | $2,511.89 | $3,235.94 | $8,912.51 |
Emblem Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $4,168.69 | Professional | None | $2,187.76 | $2,691.53 | $4,168.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $2,041.74 Typical High $3,715.35 | Professional | None | $1,047.13 | $2,041.74 | $3,715.35 |
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 $1,819.70 Median $1,819.70 Typical High $4,570.88 | Professional | None | $1,819.70 | $1,819.70 | $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 $1,548.82 Median $2,511.89 Typical High $5,495.41 | Professional | None | $1,548.82 | $2,511.89 | $5,495.41 |
Univera Setting Facility Modifier None Typical Low $1,230.27 Median $2,187.76 Typical High $5,370.32 | Facility | None | $1,230.27 | $2,187.76 | $5,370.32 |
Univera Setting Professional Modifier None Typical Low $1,230.27 Median $2,041.74 Typical High $3,715.35 | Professional | None | $1,230.27 | $2,041.74 | $3,715.35 |
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 $1,737.80 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,737.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,621.81 |
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 $199.53 Median $389.05 Typical High $707.95 | Professional | 55 · Aftercare only | $199.53 | $389.05 | $707.95 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $204.17 Typical High $371.54 | Professional | 56 · Pre-op care only | $104.71 | $204.17 | $371.54 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,445.44 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $758.58 | $1,445.44 | $2,691.53 |
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 $199.53 Median $389.05 Typical High $1,071.52 | Professional | 55 · Aftercare only | $199.53 | $389.05 | $1,071.52 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $204.17 Typical High $562.34 | Professional | 56 · Pre-op care only | $104.71 | $204.17 | $562.34 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,445.44 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $758.58 | $1,445.44 | $2,691.53 |
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· 44th of 51
$2,089
AK $9,333TX $1,023
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.