How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,122 to $11,220Professionalmedian $1,995 · 10th to 90th $1,622 to $4,266
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 $2,290.87 Median $2,290.87 Typical High $4,897.79 | Professional | None | $2,290.87 | $2,290.87 | $4,897.79 |
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 $1,698.24 Median $1,995.26 Typical High $3,801.89 | Professional | None | $1,698.24 | $1,995.26 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,258.93 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,071.52 | $1,258.93 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $323.59 Typical High $616.60 | Professional | 80 · Assistant surgeon | $275.42 | $323.59 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $281.84 Typical High $537.03 | Professional | AS · PA/NP assist | $239.88 | $281.84 | $537.03 |
CDPHP Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,235.94 | Facility | None | $851.14 | $1,778.28 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,137.96 Typical High $7,943.28 | Professional | None | $1,584.89 | $2,137.96 | $7,943.28 |
Emblem Health Setting Facility Modifier None Typical Low $1,122.02 Median $2,187.76 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,187.76 | $7,244.36 |
Emblem Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $3,801.89 | Professional | None | $1,995.26 | $2,290.87 | $3,801.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,778.28 | $2,630.27 |
MVP Health Care Setting Facility Modifier None Typical Low $2,089.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,089.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $5,248.07 | Professional | None | $2,089.30 | $2,089.30 | $5,248.07 |
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 $1,513.56 Median $2,187.76 Typical High $5,888.44 | Professional | None | $1,513.56 | $2,187.76 | $5,888.44 |
Univera Setting Facility Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $5,888.44 | Facility | None | $1,513.56 | $1,905.46 | $5,888.44 |
Univera Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,778.28 | $2,630.27 |
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 $1,148.15 Median $1,148.15 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $501.19 | Professional | 53 · Discontinued | $457.09 | $457.09 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $380.19 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $251.19 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,778.28 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,513.56 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,202.26 | $1,513.56 | $2,454.71 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $251.19 Typical High $398.11 | Professional | 55 · Aftercare only | $194.98 | $251.19 | $398.11 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $177.83 Typical High $281.84 | Professional | 56 · Pre-op care only | $141.25 | $177.83 | $281.84 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,348.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,348.96 | $2,137.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,071.52 Median $1,412.54 Typical High $2,137.96 | Professional | 53 · Discontinued | $1,071.52 | $1,412.54 | $2,137.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,548.82 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,202.26 | $1,548.82 | $2,290.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $251.19 Typical High $575.44 | Professional | 55 · Aftercare only | $194.98 | $251.19 | $575.44 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $181.97 Typical High $407.38 | Professional | 56 · Pre-op care only | $141.25 | $181.97 | $407.38 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,380.38 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,380.38 | $1,995.26 |
Where New York sits
The same service costs 22.9 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
$2,089
AK $8,511TX $372
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.