How much rates vary
Facilitymedian $3,890 · 10th to 90th $933 to $9,772Professionalmedian $794 · 10th to 90th $631 to $1,698
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 $912.01 Median $912.01 Typical High $1,862.09 | Professional | None | $912.01 | $912.01 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,548.82 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,584.89 | Professional | None | $660.69 | $776.25 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $489.78 Typical High $977.24 | Professional | 62 · Two surgeons | $416.87 | $489.78 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $125.89 Typical High $251.19 | Professional | 80 · Assistant surgeon | $107.15 | $125.89 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $109.65 Typical High $218.78 | Professional | AS · PA/NP assist | $93.33 | $109.65 | $218.78 |
CDPHP Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,096.48 Typical High $3,235.94 | Professional | None | $630.96 | $1,096.48 | $3,235.94 |
Emblem Health Setting Facility Modifier None Typical Low $954.99 Median $1,230.27 Typical High $3,311.31 | Facility | None | $954.99 | $1,230.27 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,659.59 | Professional | None | $891.25 | $1,023.29 | $1,659.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,000.00 | Professional | None | $537.03 | $758.58 | $1,000.00 |
MVP Health Care Setting Facility Modifier None Typical Low $870.96 Median $4,786.30 Typical High $5,754.40 | Facility | None | $870.96 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,348.96 | $2,089.30 |
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 $645.65 Median $891.25 Typical High $2,398.83 | Professional | None | $645.65 | $891.25 | $2,398.83 |
Univera Setting Facility Modifier None Typical Low $588.84 Median $758.58 Typical High $2,951.21 | Facility | None | $588.84 | $758.58 | $2,951.21 |
Univera Setting Professional Modifier None Typical Low $537.03 Median $758.58 Typical High $1,000.00 | Professional | None | $537.03 | $758.58 | $1,000.00 |
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 $446.68 Median $446.68 Typical High $478.63 | Professional | 52 · Reduced service | $446.68 | $446.68 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $190.55 | Professional | 53 · Discontinued | $181.97 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $724.44 | Professional | 54 · Surgery only | $676.08 | $676.08 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $95.50 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $676.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $645.65 Typical High $870.96 | Professional | 54 · Surgery only | $467.74 | $645.65 | $870.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $104.71 Typical High $141.25 | Professional | 55 · Aftercare only | $75.86 | $104.71 | $141.25 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $74.13 Typical High $100.00 | Professional | 56 · Pre-op care only | $53.70 | $74.13 | $100.00 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $575.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $407.38 | $575.44 | $758.58 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $562.34 Typical High $812.83 | Professional | 53 · Discontinued | $407.38 | $562.34 | $812.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $645.65 Typical High $870.96 | Professional | 54 · Surgery only | $467.74 | $645.65 | $870.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $104.71 Typical High $218.78 | Professional | 55 · Aftercare only | $75.86 | $104.71 | $218.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $74.13 Typical High $158.49 | Professional | 56 · Pre-op care only | $53.70 | $74.13 | $158.49 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $575.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $407.38 | $575.44 | $758.58 |
Where New York sits
The same service costs 6.2 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
$832
AK $3,311TX $537
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.