How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,202 to $14,125Professionalmedian $2,951 · 10th to 90th $2,344 to $6,166
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 $3,548.13 Median $3,548.13 Typical High $5,623.41 | Professional | None | $3,548.13 | $3,548.13 | $5,623.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,511.89 Median $2,951.21 Typical High $5,754.40 | Professional | None | $2,511.89 | $2,951.21 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $1,862.09 Typical High $3,630.78 | Professional | 62 · Two surgeons | $1,584.89 | $1,862.09 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $467.74 Typical High $933.25 | Professional | 80 · Assistant surgeon | $398.11 | $467.74 | $933.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $407.38 Typical High $812.83 | Professional | AS · PA/NP assist | $346.74 | $407.38 | $812.83 |
CDPHP Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $5,011.87 | Facility | None | $851.14 | $1,778.28 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,162.28 Typical High $11,748.98 | Professional | None | $3,090.30 | $3,162.28 | $11,748.98 |
Emblem Health Setting Facility Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $10,964.78 | Facility | None | $1,905.46 | $3,162.28 | $10,964.78 |
Emblem Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,630.78 Typical High $5,888.44 | Professional | None | $3,388.44 | $3,630.78 | $5,888.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,691.53 Typical High $3,715.35 | Professional | None | $1,995.26 | $2,691.53 | $3,715.35 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,786.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $7,079.46 | Professional | None | $2,454.71 | $2,454.71 | $7,079.46 |
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 $2,290.87 Median $3,162.28 Typical High $9,120.11 | Professional | None | $2,290.87 | $3,162.28 | $9,120.11 |
Univera Setting Facility Modifier None Typical Low $2,137.96 Median $2,187.76 Typical High $7,413.10 | Facility | None | $2,137.96 | $2,187.76 | $7,413.10 |
Univera Setting Professional Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,570.40 | $3,548.13 |
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 $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,630.27 Median $2,630.27 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,630.27 | $2,630.27 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | 55 · Aftercare only | $524.81 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,454.71 Median $2,454.71 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,454.71 | $2,454.71 | $2,511.89 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,290.87 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,698.24 | $2,290.87 | $3,162.28 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $371.54 Typical High $512.86 | Professional | 55 · Aftercare only | $281.84 | $371.54 | $512.86 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $269.15 Typical High $371.54 | Professional | 56 · Pre-op care only | $199.53 | $269.15 | $371.54 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $2,041.74 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,513.56 | $2,041.74 | $2,818.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,548.82 Median $2,137.96 Typical High $3,019.95 | Professional | 53 · Discontinued | $1,548.82 | $2,137.96 | $3,019.95 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $2,290.87 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,698.24 | $2,290.87 | $3,090.30 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $371.54 Typical High $812.83 | Professional | 55 · Aftercare only | $281.84 | $371.54 | $812.83 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $269.15 Typical High $575.44 | Professional | 56 · Pre-op care only | $199.53 | $269.15 | $575.44 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $2,041.74 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,513.56 | $2,041.74 | $2,754.23 |
Where New York sits
The same service costs 12.6 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· 39th of 51
$3,020
AK $12,023TX $955
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.