How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,047 to $13,490Professionalmedian $977 · 10th to 90th $794 to $2,042
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 $1,096.48 Median $1,096.48 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,096.48 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $7,413.10 Typical High $14,791.08 | Facility | None | $1,737.80 | $7,413.10 | $14,791.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,905.46 | Professional | None | $812.83 | $954.99 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $602.56 Typical High $1,174.90 | Professional | 62 · Two surgeons | $512.86 | $602.56 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $151.36 Typical High $302.00 | Professional | 80 · Assistant surgeon | $128.82 | $151.36 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $131.83 Typical High $263.03 | Professional | AS · PA/NP assist | $112.20 | $131.83 | $263.03 |
CDPHP Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
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 $1,000.00 Median $1,258.93 Typical High $3,801.89 | Professional | None | $1,000.00 | $1,258.93 | $3,801.89 |
Emblem Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $3,715.35 | Facility | None | $1,071.52 | $1,230.27 | $3,715.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,230.27 | $1,995.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,202.26 | Professional | None | $660.69 | $891.25 | $1,202.26 |
MVP Health Care Setting Facility Modifier None Typical Low $1,023.29 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,023.29 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $2,511.89 | Professional | None | $1,380.38 | $1,479.11 | $2,511.89 |
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 $758.58 Median $1,071.52 Typical High $2,951.21 | Professional | None | $758.58 | $1,071.52 | $2,951.21 |
Univera Setting Facility Modifier None Typical Low $707.95 Median $912.01 Typical High $3,801.89 | Facility | None | $707.95 | $912.01 | $3,801.89 |
Univera Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,202.26 | Professional | None | $660.69 | $891.25 | $1,202.26 |
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 $549.54 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $549.54 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $234.42 | Professional | 53 · Discontinued | $218.78 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $870.96 | Professional | 54 · Surgery only | $812.83 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $173.78 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $117.49 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $812.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $776.25 Typical High $1,148.15 | Professional | 54 · Surgery only | $562.34 | $776.25 | $1,148.15 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $125.89 Typical High $186.21 | Professional | 55 · Aftercare only | $91.20 | $125.89 | $186.21 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $89.13 Typical High $134.90 | Professional | 56 · Pre-op care only | $66.07 | $89.13 | $134.90 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $691.83 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $501.19 | $691.83 | $1,023.29 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $676.08 Typical High $977.24 | Professional | 53 · Discontinued | $501.19 | $676.08 | $977.24 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $776.25 Typical High $1,047.13 | Professional | 54 · Surgery only | $562.34 | $776.25 | $1,047.13 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $125.89 Typical High $269.15 | Professional | 55 · Aftercare only | $91.20 | $125.89 | $269.15 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $89.13 Typical High $190.55 | Professional | 56 · Pre-op care only | $66.07 | $89.13 | $190.55 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $691.83 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $501.19 | $691.83 | $912.01 |
Where New York sits
The same service costs 6.8 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
$1,000
AK $3,981TX $589
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.