How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,175 to $11,220Professionalmedian $2,344 · 10th to 90th $1,862 to $4,898
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 $2,630.27 Median $2,630.27 Typical High $5,623.41 | Professional | None | $2,630.27 | $2,630.27 | $5,623.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,456.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $4,365.16 | Professional | None | $1,995.26 | $2,344.23 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,479.11 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,258.93 | $1,479.11 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $371.54 Typical High $707.95 | Professional | 80 · Assistant surgeon | $316.23 | $371.54 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $323.59 Typical High $616.60 | Professional | AS · PA/NP assist | $275.42 | $323.59 | $616.60 |
CDPHP Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,715.35 | Facility | None | $851.14 | $1,778.28 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,454.71 Typical High $9,120.11 | Professional | None | $1,819.70 | $2,454.71 | $9,120.11 |
Emblem Health Setting Facility Modifier None Typical Low $1,737.80 Median $2,630.27 Typical High $8,128.31 | Facility | None | $1,737.80 | $2,630.27 | $8,128.31 |
Emblem Health Setting Professional Modifier None Typical Low $2,290.87 Median $2,630.27 Typical High $4,265.80 | Professional | None | $2,290.87 | $2,630.27 | $4,265.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,621.81 | $2,041.74 | $3,019.95 |
MVP Health Care Setting Facility Modifier None Typical Low $2,454.71 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,454.71 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $6,025.60 | Professional | None | $2,951.21 | $2,951.21 | $6,025.60 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $2,511.89 Typical High $6,760.83 | Professional | None | $1,737.80 | $2,511.89 | $6,760.83 |
Univera Setting Facility Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $6,025.60 | Facility | None | $1,737.80 | $2,187.76 | $6,025.60 |
Univera Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,621.81 | $2,041.74 | $3,019.95 |
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 $1,318.26 Median $1,318.26 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,318.26 | $1,318.26 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $575.44 | Professional | 53 · Discontinued | $524.81 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $1,995.26 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,995.26 | $1,995.26 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | 55 · Aftercare only | $398.11 | $398.11 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $288.40 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,862.09 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,862.09 | $2,041.74 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,737.80 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,380.38 | $1,737.80 | $2,818.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $281.84 Typical High $457.09 | Professional | 55 · Aftercare only | $223.87 | $281.84 | $457.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $204.17 Typical High $323.59 | Professional | 56 · Pre-op care only | $162.18 | $204.17 | $323.59 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,548.82 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,548.82 | $2,454.71 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,230.27 Median $1,621.81 Typical High $2,454.71 | Professional | 53 · Discontinued | $1,230.27 | $1,621.81 | $2,454.71 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,778.28 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,380.38 | $1,778.28 | $2,630.27 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $288.40 Typical High $660.69 | Professional | 55 · Aftercare only | $223.87 | $288.40 | $660.69 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $208.93 Typical High $467.74 | Professional | 56 · Pre-op care only | $162.18 | $208.93 | $467.74 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,584.89 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,584.89 | $2,290.87 |
Where New York sits
The same service costs 11.0 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· 41st of 51
$2,455
AK $9,772TX $891
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.