How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,479 to $11,482Professionalmedian $1,660 · 10th to 90th $1,318 to $3,467
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 $5,248.07 Typical High $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $4,073.80 | Professional | None | $1,862.09 | $1,862.09 | $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 $1,412.54 Median $1,659.59 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,659.59 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,047.13 Typical High $1,995.26 | Professional | 62 · Two surgeons | $891.25 | $1,047.13 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $263.03 Typical High $512.86 | Professional | 80 · Assistant surgeon | $223.87 | $263.03 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $234.42 Typical High $446.68 | Professional | AS · PA/NP assist | $199.53 | $234.42 | $446.68 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,412.54 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $6,456.54 | Professional | None | $1,318.26 | $1,778.28 | $6,456.54 |
Emblem Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,995.26 Typical High $6,165.95 | Facility | None | $1,258.93 | $1,995.26 | $6,165.95 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,737.80 | $1,995.26 | $3,235.94 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,513.56 | $2,137.96 |
MVP Health Care Setting Facility Modifier None Typical Low $1,778.28 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,778.28 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $4,265.80 | Professional | None | $1,698.24 | $1,698.24 | $4,265.80 |
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 $1,288.25 Median $1,778.28 Typical High $4,786.30 | Professional | None | $1,288.25 | $1,778.28 | $4,786.30 |
Univera Setting Facility Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $5,128.61 | Facility | None | $1,258.93 | $1,584.89 | $5,128.61 |
Univera Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,513.56 | $2,137.96 |
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 $933.25 Median $933.25 Typical High $1,047.13 | Professional | 52 · Reduced service | $933.25 | $933.25 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $416.87 | Professional | 53 · Discontinued | $380.19 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $316.23 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $208.93 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,445.44 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,318.26 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,000.00 | $1,318.26 | $1,862.09 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $213.80 Typical High $302.00 | Professional | 55 · Aftercare only | $162.18 | $213.80 | $302.00 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $151.36 Typical High $213.80 | Professional | 56 · Pre-op care only | $114.82 | $151.36 | $213.80 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,148.15 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $870.96 | $1,148.15 | $1,621.81 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $1,148.15 Typical High $1,737.80 | Professional | 53 · Discontinued | $870.96 | $1,148.15 | $1,737.80 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,318.26 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,000.00 | $1,318.26 | $1,862.09 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $213.80 Typical High $467.74 | Professional | 55 · Aftercare only | $162.18 | $213.80 | $467.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $151.36 Typical High $338.84 | Professional | 56 · Pre-op care only | $114.82 | $151.36 | $338.84 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,148.15 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $870.96 | $1,148.15 | $1,621.81 |
Where New York sits
The same service costs 7.1 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· 44th of 51
$1,698
AK $7,079TX $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.