How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,318 to $14,125Professionalmedian $794 · 10th to 90th $631 to $1,380
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 $1,819.70 Median $5,754.40 Typical High $10,964.78 | Facility | None | $1,819.70 | $5,754.40 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $912.01 | Professional | None | $812.83 | $812.83 | $912.01 |
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 $630.96 Median $741.31 Typical High $1,148.15 | Professional | None | $630.96 | $741.31 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $467.74 Typical High $707.95 | Professional | 62 · Two surgeons | $398.11 | $467.74 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $120.23 Typical High $173.78 | Professional | 80 · Assistant surgeon | $102.33 | $120.23 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $104.71 Typical High $158.49 | Professional | AS · PA/NP assist | $89.13 | $104.71 | $158.49 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $8,128.31 Typical High $16,595.87 | Facility | None | $1,445.44 | $8,128.31 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,905.46 | Professional | None | $851.14 | $851.14 | $1,905.46 |
Emblem Health Setting Facility Modifier None Typical Low $912.01 Median $1,288.25 Typical High $3,467.37 | Facility | None | $912.01 | $1,288.25 | $3,467.37 |
Emblem Health Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,513.56 | Professional | None | $812.83 | $1,000.00 | $1,513.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $489.78 Median $794.33 Typical High $1,122.02 | Professional | None | $489.78 | $794.33 | $1,122.02 |
MVP Health Care Setting Facility Modifier None Typical Low $891.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $891.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $2,137.96 | Professional | None | $870.96 | $977.24 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,202.26 | $3,162.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $2,089.30 | Professional | None | $602.56 | $870.96 | $2,089.30 |
Univera Setting Facility Modifier None Typical Low $575.44 Median $812.83 Typical High $3,715.35 | Facility | None | $575.44 | $812.83 | $3,715.35 |
Univera Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $1,122.02 | Professional | None | $575.44 | $794.33 | $1,122.02 |
17 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 $407.38 Median $407.38 Typical High $457.09 | Professional | 52 · Reduced service | $407.38 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $181.97 | Professional | 53 · Discontinued | $162.18 | $162.18 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $616.60 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $138.04 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $91.20 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $645.65 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $630.96 Typical High $891.25 | Professional | 54 · Surgery only | $380.19 | $630.96 | $891.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $165.96 Typical High $234.42 | Professional | 55 · Aftercare only | $102.33 | $165.96 | $234.42 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $79.43 Typical High $112.20 | Professional | 56 · Pre-op care only | $48.98 | $79.43 | $112.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $549.54 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $338.84 | $549.54 | $776.25 |
Highmark BCBS Setting Facility Modifier 59 · Distinct service Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | 59 · Distinct service | $512.86 | $512.86 | $512.86 |
Highmark BCBS Setting Professional Modifier 59 · Distinct service Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 59 · Distinct service | $1,174.90 | $1,174.90 | $1,174.90 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $645.65 | Professional | 53 · Discontinued | $436.52 | $436.52 | $645.65 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $630.96 Typical High $891.25 | Professional | 54 · Surgery only | $380.19 | $630.96 | $891.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $165.96 Typical High $467.74 | Professional | 55 · Aftercare only | $102.33 | $165.96 | $467.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $79.43 Typical High $223.87 | Professional | 56 · Pre-op care only | $48.98 | $79.43 | $223.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $549.54 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $338.84 | $549.54 | $812.83 |
Where New York sits
The same service costs 7.6 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· 46th of 51
$794
AK $3,548TX $468
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.