How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,413 to $11,749Professionalmedian $1,175 · 10th to 90th $955 to $2,570
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 $1,905.46 Median $6,165.95 Typical High $11,748.98 | Facility | None | $1,905.46 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $4,073.80 | Professional | None | $1,288.25 | $1,288.25 | $4,073.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,174.90 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $741.31 Typical High $1,479.11 | Professional | 62 · Two surgeons | $630.96 | $741.31 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $186.21 Typical High $371.54 | Professional | 80 · Assistant surgeon | $158.49 | $186.21 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $162.18 Typical High $331.13 | Professional | AS · PA/NP assist | $138.04 | $162.18 | $331.13 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,584.89 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $4,677.35 | Professional | None | $977.24 | $1,288.25 | $4,677.35 |
Emblem Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $4,570.88 | Facility | None | $1,202.26 | $1,445.44 | $4,570.88 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,445.44 | $2,398.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,621.81 | Professional | None | $870.96 | $1,122.02 | $1,621.81 |
MVP Health Care Setting Facility Modifier None Typical Low $1,230.27 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,230.27 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $3,162.28 | Professional | None | $1,513.56 | $1,513.56 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $3,548.13 | Professional | None | $933.25 | $1,318.26 | $3,548.13 |
Univera Setting Facility Modifier None Typical Low $933.25 Median $1,174.90 Typical High $4,073.80 | Facility | None | $933.25 | $1,174.90 | $4,073.80 |
Univera Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,584.89 | Professional | None | $870.96 | $1,122.02 | $1,584.89 |
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 $645.65 Median $645.65 Typical High $776.25 | Professional | 52 · Reduced service | $645.65 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $309.03 | Professional | 53 · Discontinued | $257.04 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,071.52 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $954.99 Typical High $1,479.11 | Professional | 54 · Surgery only | $741.31 | $954.99 | $1,479.11 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $154.88 Typical High $245.47 | Professional | 55 · Aftercare only | $120.23 | $154.88 | $245.47 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $112.20 Typical High $173.78 | Professional | 56 · Pre-op care only | $87.10 | $112.20 | $173.78 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $851.14 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $660.69 | $851.14 | $1,318.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $851.14 Typical High $1,288.25 | Professional | 53 · Discontinued | $645.65 | $851.14 | $1,288.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $954.99 Typical High $1,412.54 | Professional | 54 · Surgery only | $741.31 | $954.99 | $1,412.54 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $154.88 Typical High $346.74 | Professional | 55 · Aftercare only | $120.23 | $154.88 | $346.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $112.20 Typical High $251.19 | Professional | 56 · Pre-op care only | $87.10 | $112.20 | $251.19 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $851.14 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $660.69 | $851.14 | $1,230.27 |
Where New York sits
The same service costs 6.6 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
$1,230
AK $5,248TX $794
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.