How much rates vary
Facilitymedian $4,074 · 10th to 90th $955 to $11,482Professionalmedian $776 · 10th to 90th $631 to $1,549
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,819.70 | Professional | None | $870.96 | $870.96 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,570.88 Typical High $11,748.98 | Facility | None | $1,513.56 | $4,570.88 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,412.54 | Professional | None | $645.65 | $776.25 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $489.78 Typical High $891.25 | Professional | 62 · Two surgeons | $407.38 | $489.78 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $123.03 Typical High $229.09 | Professional | 80 · Assistant surgeon | $102.33 | $123.03 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $107.15 Typical High $199.53 | Professional | AS · PA/NP assist | $89.13 | $107.15 | $199.53 |
CDPHP Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $794.33 Median $812.83 Typical High $2,754.23 | Professional | None | $794.33 | $812.83 | $2,754.23 |
Emblem Health Setting Facility Modifier None Typical Low $912.01 Median $1,659.59 Typical High $3,388.44 | Facility | None | $912.01 | $1,659.59 | $3,388.44 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,737.80 | Professional | None | $870.96 | $1,000.00 | $1,737.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $1,258.93 | Professional | None | $524.81 | $741.31 | $1,258.93 |
MVP Health Care Setting Facility Modifier None Typical Low $851.14 Median $5,754.40 Typical High $89,125.09 | Facility | None | $851.14 | $5,754.40 | $89,125.09 |
MVP Health Care Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,995.26 | Professional | None | $707.95 | $707.95 | $1,995.26 |
United Setting Facility Modifier None Typical Low $575.44 Median $2,187.76 Typical High $21,877.62 | Facility | None | $575.44 | $2,187.76 | $21,877.62 |
United Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $2,290.87 | Professional | None | $660.69 | $891.25 | $2,290.87 |
Univera Setting Facility Modifier None Typical Low $524.81 Median $724.44 Typical High $3,630.78 | Facility | None | $524.81 | $724.44 | $3,630.78 |
Univera Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $1,288.25 | Professional | None | $524.81 | $741.31 | $1,288.25 |
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 $436.52 Median $436.52 Typical High $524.81 | Professional | 52 · Reduced service | $436.52 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $208.93 | Professional | 53 · Discontinued | $173.78 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $776.25 | Professional | 54 · Surgery only | $660.69 | $660.69 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $154.88 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $724.44 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $691.83 Typical High $1,202.26 | Professional | 54 · Surgery only | $478.63 | $691.83 | $1,202.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $51.29 Typical High $91.20 | Professional | 55 · Aftercare only | $36.31 | $51.29 | $91.20 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $66.07 Typical High $117.49 | Professional | 56 · Pre-op care only | $46.77 | $66.07 | $117.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $616.60 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $436.52 | $616.60 | $1,096.48 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $691.83 Typical High $1,202.26 | Professional | 54 · Surgery only | $478.63 | $691.83 | $1,202.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $51.29 Typical High $104.71 | Professional | 55 · Aftercare only | $36.31 | $51.29 | $104.71 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $66.07 Typical High $134.90 | Professional | 56 · Pre-op care only | $46.77 | $66.07 | $134.90 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $616.60 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $436.52 | $616.60 | $1,096.48 |
Where New York sits
The same service costs 4.6 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· 47th of 51
$813
AK $3,162TX $692
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.