How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,202 to $14,125Professionalmedian $3,236 · 10th to 90th $2,512 to $6,310
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 $3,630.78 Median $3,630.78 Typical High $7,244.36 | Professional | None | $3,630.78 | $3,630.78 | $7,244.36 |
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 $2,630.27 Median $3,162.28 Typical High $5,754.40 | Professional | None | $2,630.27 | $3,162.28 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,621.81 Median $1,949.84 Typical High $3,630.78 | Professional | 62 · Two surgeons | $1,621.81 | $1,949.84 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $501.19 Typical High $933.25 | Professional | 80 · Assistant surgeon | $416.87 | $501.19 | $933.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $436.52 Typical High $812.83 | Professional | AS · PA/NP assist | $363.08 | $436.52 | $812.83 |
CDPHP Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Professional | None | $4,466.84 | $4,466.84 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $5,370.32 | Facility | None | $851.14 | $1,778.28 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $11,220.18 | Professional | None | $3,235.94 | $3,311.31 | $11,220.18 |
Emblem Health Setting Facility Modifier None Typical Low $3,235.94 Median $4,677.35 Typical High $11,748.98 | Facility | None | $3,235.94 | $4,677.35 | $11,748.98 |
Emblem Health Setting Professional Modifier None Typical Low $3,311.31 Median $3,801.89 Typical High $6,760.83 | Professional | None | $3,311.31 | $3,801.89 | $6,760.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,818.38 Typical High $4,570.88 | Professional | None | $2,089.30 | $2,818.38 | $4,570.88 |
MVP Health Care Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
MVP Health Care Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $8,317.64 | Professional | None | $3,630.78 | $3,630.78 | $8,317.64 |
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 $2,570.40 Median $3,630.78 Typical High $9,549.93 | Professional | None | $2,570.40 | $3,630.78 | $9,549.93 |
Univera Setting Facility Modifier None Typical Low $2,238.72 Median $2,951.21 Typical High $10,232.93 | Facility | None | $2,238.72 | $2,951.21 | $10,232.93 |
Univera Setting Professional Modifier None Typical Low $2,089.30 Median $2,818.38 Typical High $4,570.88 | Professional | None | $2,089.30 | $2,818.38 | $4,570.88 |
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 $1,819.70 Median $1,819.70 Typical High $2,137.96 | Professional | 52 · Reduced service | $1,819.70 | $1,819.70 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $724.44 Typical High $851.14 | Professional | 53 · Discontinued | $724.44 | $724.44 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $2,754.23 Typical High $3,235.94 | Professional | 54 · Surgery only | $2,754.23 | $2,754.23 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $549.54 Typical High $645.65 | Professional | 55 · Aftercare only | $549.54 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $363.08 Typical High $426.58 | Professional | 56 · Pre-op care only | $363.08 | $363.08 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,570.40 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,570.40 | $3,019.95 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,630.27 Typical High $4,365.16 | Professional | 54 · Surgery only | $1,949.84 | $2,630.27 | $4,365.16 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $199.53 Typical High $323.59 | Professional | 55 · Aftercare only | $147.91 | $199.53 | $323.59 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $257.04 Typical High $416.87 | Professional | 56 · Pre-op care only | $190.55 | $257.04 | $416.87 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,398.83 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,398.83 | $3,890.45 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,691.53 Typical High $4,168.69 | Professional | 54 · Surgery only | $1,949.84 | $2,691.53 | $4,168.69 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $199.53 Typical High $426.58 | Professional | 55 · Aftercare only | $147.91 | $199.53 | $426.58 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $257.04 Typical High $549.54 | Professional | 56 · Pre-op care only | $190.55 | $257.04 | $549.54 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,398.83 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,398.83 | $3,801.89 |
Where New York sits
The same service costs 6.3 times more in Alaska than in Arkansas. 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· 40th of 51
$3,311
AK $12,589AR $1,995
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.