How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,096 to $13,183Professionalmedian $1,585 · 10th to 90th $1,202 to $3,090
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 $1,778.28 Median $1,778.28 Typical High $3,467.37 | Professional | None | $1,778.28 | $1,778.28 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $7,413.10 Typical High $14,454.40 | Facility | None | $1,659.59 | $7,413.10 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,513.56 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $239.88 Typical High $446.68 | Professional | 80 · Assistant surgeon | $199.53 | $239.88 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $213.80 Typical High $398.11 | Professional | AS · PA/NP assist | $177.83 | $213.80 | $398.11 |
CDPHP Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
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 $1,584.89 Median $1,584.89 Typical High $5,495.41 | Professional | None | $1,584.89 | $1,584.89 | $5,495.41 |
Emblem Health Setting Facility Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $5,754.40 | Facility | None | $1,584.89 | $2,344.23 | $5,754.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $3,311.31 | Professional | None | $1,621.81 | $1,862.09 | $3,311.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,380.38 | $2,137.96 |
MVP Health Care Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,621.81 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,981.07 | Professional | None | $1,659.59 | $1,659.59 | $3,981.07 |
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 $1,258.93 Median $1,778.28 Typical High $4,570.88 | Professional | None | $1,258.93 | $1,778.28 | $4,570.88 |
Univera Setting Facility Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $4,897.79 | Facility | None | $1,096.48 | $1,445.44 | $4,897.79 |
Univera Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,380.38 | $2,137.96 |
14 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 $891.25 Median $891.25 Typical High $1,023.29 | Professional | 52 · Reduced service | $891.25 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $416.87 | Professional | 53 · Discontinued | $354.81 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $208.93 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,445.44 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,288.25 Typical High $2,041.74 | Professional | 54 · Surgery only | $954.99 | $1,288.25 | $2,041.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $97.72 Typical High $154.88 | Professional | 55 · Aftercare only | $70.79 | $97.72 | $154.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $125.89 Typical High $199.53 | Professional | 56 · Pre-op care only | $91.20 | $125.89 | $199.53 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,174.90 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $851.14 | $1,174.90 | $1,862.09 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,288.25 Typical High $2,041.74 | Professional | 54 · Surgery only | $954.99 | $1,288.25 | $2,041.74 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $97.72 Typical High $208.93 | Professional | 55 · Aftercare only | $70.79 | $97.72 | $208.93 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $125.89 Typical High $263.03 | Professional | 56 · Pre-op care only | $91.20 | $125.89 | $263.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,174.90 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $851.14 | $1,174.90 | $1,862.09 |
Where New York sits
The same service costs 5.6 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· 43rd of 51
$1,585
AK $6,166TX $1,096
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.