How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,380 to $11,220Professionalmedian $1,318 · 10th to 90th $1,047 to $2,884
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $4,365.16 | Professional | None | $1,621.81 | $1,621.81 | $4,365.16 |
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 $1,096.48 Median $1,288.25 Typical High $2,630.27 | Professional | None | $1,096.48 | $1,288.25 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $812.83 Typical High $1,659.59 | Professional | 62 · Two surgeons | $691.83 | $812.83 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $208.93 Typical High $426.58 | Professional | 80 · Assistant surgeon | $177.83 | $208.93 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $181.97 Typical High $371.54 | Professional | AS · PA/NP assist | $154.88 | $181.97 | $371.54 |
CDPHP Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,737.80 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $5,495.41 | Professional | None | $1,071.52 | $1,445.44 | $5,495.41 |
Emblem Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $4,897.79 | Facility | None | $1,202.26 | $1,584.89 | $4,897.79 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,548.82 | $2,570.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,778.28 | Professional | None | $954.99 | $1,258.93 | $1,778.28 |
MVP Health Care Setting Facility Modifier None Typical Low $1,548.82 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,548.82 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $3,467.37 | Professional | None | $1,862.09 | $1,862.09 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,232.93 | Facility | None | $1,230.27 | $3,162.28 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $3,890.45 | Professional | None | $1,023.29 | $1,445.44 | $3,890.45 |
Univera Setting Facility Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $4,677.35 | Facility | None | $1,023.29 | $1,288.25 | $4,677.35 |
Univera Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,737.80 | Professional | None | $954.99 | $1,258.93 | $1,737.80 |
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 $794.33 Median $794.33 Typical High $851.14 | Professional | 52 · Reduced service | $794.33 | $794.33 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $338.84 | Professional | 53 · Discontinued | $323.59 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $257.04 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $169.82 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,202.26 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,047.13 Typical High $1,548.82 | Professional | 54 · Surgery only | $812.83 | $1,047.13 | $1,548.82 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $169.82 Typical High $251.19 | Professional | 55 · Aftercare only | $131.83 | $169.82 | $251.19 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $120.23 Typical High $177.83 | Professional | 56 · Pre-op care only | $95.50 | $120.23 | $177.83 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $933.25 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $724.44 | $933.25 | $1,348.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $933.25 Typical High $1,412.54 | Professional | 53 · Discontinued | $707.95 | $933.25 | $1,412.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,047.13 Typical High $1,479.11 | Professional | 54 · Surgery only | $812.83 | $1,047.13 | $1,479.11 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $169.82 Typical High $389.05 | Professional | 55 · Aftercare only | $131.83 | $169.82 | $389.05 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $120.23 Typical High $275.42 | Professional | 56 · Pre-op care only | $95.50 | $120.23 | $275.42 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $933.25 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $724.44 | $933.25 | $1,318.26 |
Where New York sits
The same service costs 6.5 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
$1,380
AK $5,754TX $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.