How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,514 to $12,882Professionalmedian $1,622 · 10th to 90th $1,259 to $2,692
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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,698.24 | Professional | None | $1,659.59 | $1,659.59 | $1,698.24 |
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 $1,348.96 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,348.96 | $1,584.89 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,000.00 Typical High $1,380.38 | Professional | 62 · Two surgeons | $851.14 | $1,000.00 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $251.19 Typical High $346.74 | Professional | 80 · Assistant surgeon | $213.80 | $251.19 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $218.78 Typical High $302.00 | Professional | AS · PA/NP assist | $186.21 | $218.78 | $302.00 |
CDPHP Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
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 $1,621.81 Median $1,621.81 Typical High $3,715.35 | Professional | None | $1,621.81 | $1,621.81 | $3,715.35 |
Emblem Health Setting Facility Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $5,754.40 | Facility | None | $1,737.80 | $2,398.83 | $5,754.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,479.11 | $1,737.80 | $2,754.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,380.38 Typical High $2,137.96 | Professional | None | $912.01 | $1,380.38 | $2,137.96 |
MVP Health Care Setting Facility Modifier None Typical Low $1,995.26 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,995.26 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $4,168.69 | Professional | None | $1,698.24 | $2,344.23 | $4,168.69 |
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 $1,047.13 Median $1,659.59 Typical High $3,890.45 | Professional | None | $1,047.13 | $1,659.59 | $3,890.45 |
Univera Setting Facility Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $7,585.78 | Facility | None | $1,071.52 | $1,479.11 | $7,585.78 |
Univera Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,380.38 | $2,137.96 |
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 $831.76 Median $831.76 Typical High $851.14 | Professional | 52 · Reduced service | $831.76 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $338.84 | Professional | 53 · Discontinued | $331.13 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $169.82 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,096.48 Typical High $1,659.59 | Professional | 54 · Surgery only | $724.44 | $1,096.48 | $1,659.59 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $295.12 Typical High $446.68 | Professional | 55 · Aftercare only | $190.55 | $295.12 | $446.68 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $138.04 Typical High $213.80 | Professional | 56 · Pre-op care only | $91.20 | $138.04 | $213.80 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $954.99 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $630.96 | $954.99 | $1,479.11 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $870.96 Typical High $1,258.93 | Professional | 53 · Discontinued | $851.14 | $870.96 | $1,258.93 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,096.48 Typical High $1,659.59 | Professional | 54 · Surgery only | $724.44 | $1,096.48 | $1,659.59 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $295.12 Typical High $870.96 | Professional | 55 · Aftercare only | $190.55 | $295.12 | $870.96 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $138.04 Typical High $416.87 | Professional | 56 · Pre-op care only | $91.20 | $138.04 | $416.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $954.99 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $630.96 | $954.99 | $1,479.11 |
Where New York sits
The same service costs 20.4 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
$1,622
AK $6,607TX $324
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.