How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,096 to $13,183Professionalmedian $1,202 · 10th to 90th $912 to $2,344
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 $1,380.38 Median $1,380.38 Typical High $2,691.53 | Professional | None | $1,380.38 | $1,380.38 | $2,691.53 |
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 $954.99 Median $1,148.15 Typical High $2,137.96 | Professional | None | $954.99 | $1,148.15 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $724.44 Typical High $1,348.96 | Professional | 62 · Two surgeons | $602.56 | $724.44 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $186.21 Typical High $346.74 | Professional | 80 · Assistant surgeon | $154.88 | $186.21 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $162.18 Typical High $302.00 | Professional | AS · PA/NP assist | $134.90 | $162.18 | $302.00 |
CDPHP Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $1,202.26 Median $1,230.27 Typical High $4,168.69 | Professional | None | $1,202.26 | $1,230.27 | $4,168.69 |
Emblem Health Setting Facility Modifier None Typical Low $1,380.38 Median $2,511.89 Typical High $4,786.30 | Facility | None | $1,380.38 | $2,511.89 | $4,786.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,445.44 | $2,570.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,621.81 | Professional | None | $776.25 | $1,071.52 | $1,621.81 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,288.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,187.76 | $3,019.95 |
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 $977.24 Median $1,380.38 Typical High $3,467.37 | Professional | None | $977.24 | $1,380.38 | $3,467.37 |
Univera Setting Facility Modifier None Typical Low $831.76 Median $1,096.48 Typical High $5,623.41 | Facility | None | $831.76 | $1,096.48 | $5,623.41 |
Univera Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $1,621.81 | Professional | None | $776.25 | $1,071.52 | $1,621.81 |
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 $691.83 Median $691.83 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $316.23 | Professional | 53 · Discontinued | $275.42 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $234.42 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,096.48 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,000.00 Typical High $1,548.82 | Professional | 54 · Surgery only | $724.44 | $1,000.00 | $1,548.82 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $75.86 Typical High $117.49 | Professional | 55 · Aftercare only | $54.95 | $75.86 | $117.49 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $97.72 Typical High $151.36 | Professional | 56 · Pre-op care only | $70.79 | $97.72 | $151.36 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $912.01 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $660.69 | $912.01 | $1,412.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,000.00 Typical High $1,513.56 | Professional | 54 · Surgery only | $724.44 | $1,000.00 | $1,513.56 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $75.86 Typical High $158.49 | Professional | 55 · Aftercare only | $54.95 | $75.86 | $158.49 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $97.72 Typical High $204.17 | Professional | 56 · Pre-op care only | $70.79 | $97.72 | $204.17 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $912.01 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $660.69 | $912.01 | $1,348.96 |
Where New York sits
The same service costs 5.5 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
$1,230
AK $4,677TX $851
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.