How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,122 to $11,220Professionalmedian $1,862 · 10th to 90th $1,479 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 $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 $2,137.96 Median $2,137.96 Typical High $3,630.78 | Professional | None | $2,137.96 | $2,137.96 | $3,630.78 |
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 $1,584.89 Median $1,862.09 Typical High $3,548.13 | Professional | None | $1,584.89 | $1,862.09 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,174.90 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,000.00 | $1,174.90 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $295.12 Typical High $562.34 | Professional | 80 · Assistant surgeon | $251.19 | $295.12 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $263.03 Typical High $501.19 | Professional | AS · PA/NP assist | $223.87 | $263.03 | $501.19 |
CDPHP Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,019.95 | Facility | None | $851.14 | $1,778.28 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $7,413.10 | Professional | None | $1,479.11 | $1,995.26 | $7,413.10 |
Emblem Health Setting Facility Modifier None Typical Low $1,122.02 Median $2,041.74 Typical High $6,606.93 | Facility | None | $1,122.02 | $2,041.74 | $6,606.93 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $3,548.13 | Professional | None | $1,737.80 | $2,137.96 | $3,548.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,288.25 | $1,659.59 | $2,454.71 |
MVP Health Care Setting Facility Modifier None Typical Low $1,949.84 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,949.84 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $4,897.79 | Professional | None | $1,995.26 | $1,995.26 | $4,897.79 |
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 $1,412.54 Median $2,041.74 Typical High $5,370.32 | Professional | None | $1,412.54 | $2,041.74 | $5,370.32 |
Univera Setting Facility Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $5,754.40 | Facility | None | $1,412.54 | $1,778.28 | $5,754.40 |
Univera Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,288.25 | $1,659.59 | $2,454.71 |
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 $1,047.13 Median $1,047.13 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $467.74 | Professional | 53 · Discontinued | $426.58 | $426.58 | $467.74 |
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 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $346.74 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $234.42 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $234.42 |
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 $1,122.02 Median $1,412.54 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,122.02 | $1,412.54 | $2,238.72 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $229.09 Typical High $363.08 | Professional | 55 · Aftercare only | $181.97 | $229.09 | $363.08 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $165.96 Typical High $263.03 | Professional | 56 · Pre-op care only | $128.82 | $165.96 | $263.03 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,258.93 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,258.93 | $1,995.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $1,318.26 Typical High $1,949.84 | Professional | 53 · Discontinued | $977.24 | $1,318.26 | $1,949.84 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,445.44 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,122.02 | $1,445.44 | $2,089.30 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $234.42 Typical High $524.81 | Professional | 55 · Aftercare only | $181.97 | $234.42 | $524.81 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $165.96 Typical High $380.19 | Professional | 56 · Pre-op care only | $128.82 | $165.96 | $380.19 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,258.93 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,258.93 | $1,862.09 |
Where New York sits
The same service costs 7.8 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· 40th of 51
$1,950
AK $7,762TX $1,000
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.