How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,202 to $14,125Professionalmedian $3,388 · 10th to 90th $2,630 to $7,079
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 $3,890.45 Median $3,890.45 Typical High $6,456.54 | Professional | None | $3,890.45 | $3,890.45 | $6,456.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,884.03 Median $3,388.44 Typical High $6,606.93 | Professional | None | $2,884.03 | $3,388.44 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,819.70 Median $2,137.96 Typical High $4,168.69 | Professional | 62 · Two surgeons | $1,819.70 | $2,137.96 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $457.09 Median $537.03 Typical High $1,071.52 | Professional | 80 · Assistant surgeon | $457.09 | $537.03 | $1,071.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $478.63 Typical High $933.25 | Professional | AS · PA/NP assist | $398.11 | $478.63 | $933.25 |
CDPHP Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $5,888.44 | Facility | None | $851.14 | $1,778.28 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $3,388.44 Median $3,630.78 Typical High $13,489.63 | Professional | None | $3,388.44 | $3,630.78 | $13,489.63 |
Emblem Health Setting Facility Modifier None Typical Low $1,819.70 Median $3,548.13 Typical High $12,882.50 | Facility | None | $1,819.70 | $3,548.13 | $12,882.50 |
Emblem Health Setting Professional Modifier None Typical Low $3,715.35 Median $4,168.69 Typical High $6,918.31 | Professional | None | $3,715.35 | $4,168.69 | $6,918.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,290.87 Median $3,090.30 Typical High $4,265.80 | Professional | None | $2,290.87 | $3,090.30 | $4,265.80 |
MVP Health Care Setting Facility Modifier None Typical Low $3,311.31 Median $4,786.30 Typical High $5,754.40 | Facility | None | $3,311.31 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $7,943.28 | Professional | None | $2,089.30 | $2,089.30 | $7,943.28 |
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 $2,511.89 Median $3,715.35 Typical High $10,471.29 | Professional | None | $2,511.89 | $3,715.35 | $10,471.29 |
Univera Setting Facility Modifier None Typical Low $2,511.89 Median $3,235.94 Typical High $7,762.47 | Facility | None | $2,511.89 | $3,235.94 | $7,762.47 |
Univera Setting Professional Modifier None Typical Low $2,290.87 Median $3,090.30 Typical High $4,168.69 | Professional | None | $2,290.87 | $3,090.30 | $4,168.69 |
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 $1,949.84 Median $1,949.84 Typical High $2,089.30 | Professional | 52 · Reduced service | $1,949.84 | $1,949.84 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $776.25 Typical High $831.76 | Professional | 53 · Discontinued | $776.25 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $2,884.03 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,884.03 | $2,884.03 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $575.44 Typical High $616.60 | Professional | 55 · Aftercare only | $575.44 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | 56 · Pre-op care only | $389.05 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,691.53 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,691.53 | $2,884.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,691.53 Typical High $4,073.80 | Professional | 54 · Surgery only | $1,995.26 | $2,691.53 | $4,073.80 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $436.52 Typical High $660.69 | Professional | 55 · Aftercare only | $323.59 | $436.52 | $660.69 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $309.03 Typical High $467.74 | Professional | 56 · Pre-op care only | $229.09 | $309.03 | $467.74 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $2,344.23 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $1,737.80 | $2,344.23 | $3,548.13 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,778.28 Median $2,454.71 Typical High $3,467.37 | Professional | 53 · Discontinued | $1,778.28 | $2,454.71 | $3,467.37 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,691.53 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,995.26 | $2,691.53 | $3,715.35 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $436.52 Typical High $933.25 | Professional | 55 · Aftercare only | $323.59 | $436.52 | $933.25 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $309.03 Typical High $676.08 | Professional | 56 · Pre-op care only | $229.09 | $309.03 | $676.08 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $2,344.23 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $1,737.80 | $2,344.23 | $3,235.94 |
Where New York sits
The same service costs 10.7 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· 41st of 51
$3,388
AK $14,125TX $1,318
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.