How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,202 to $14,125Professionalmedian $2,188 · 10th to 90th $1,698 to $4,266
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 $2,454.71 Median $2,454.71 Typical High $4,897.79 | Professional | None | $2,454.71 | $2,454.71 | $4,897.79 |
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 $1,737.80 Median $2,089.30 Typical High $3,890.45 | Professional | None | $1,737.80 | $2,089.30 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,318.26 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,096.48 | $1,318.26 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $338.84 Typical High $630.96 | Professional | 80 · Assistant surgeon | $281.84 | $338.84 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $295.12 Typical High $549.54 | Professional | AS · PA/NP assist | $245.47 | $295.12 | $549.54 |
CDPHP Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,630.78 | Facility | None | $851.14 | $1,778.28 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,238.72 Typical High $7,585.78 | Professional | None | $2,187.76 | $2,238.72 | $7,585.78 |
Emblem Health Setting Facility Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $7,943.28 | Facility | None | $2,187.76 | $2,884.03 | $7,943.28 |
Emblem Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,630.27 Typical High $4,570.88 | Professional | None | $2,041.74 | $2,630.27 | $4,570.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,905.46 | $3,090.30 |
MVP Health Care Setting Facility Modifier None Typical Low $2,089.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,089.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $5,623.41 | Professional | None | $2,344.23 | $2,344.23 | $5,623.41 |
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 $1,698.24 Median $2,454.71 Typical High $6,456.54 | Professional | None | $1,698.24 | $2,454.71 | $6,456.54 |
Univera Setting Facility Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $8,128.31 | Facility | None | $1,513.56 | $1,995.26 | $8,128.31 |
Univera Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,905.46 | $3,090.30 |
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 $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $575.44 | Professional | 53 · Discontinued | $489.78 | $489.78 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $436.52 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $2,041.74 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,778.28 Typical High $2,951.21 | Professional | 54 · Surgery only | $1,318.26 | $1,778.28 | $2,951.21 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $134.90 Typical High $218.78 | Professional | 55 · Aftercare only | $100.00 | $134.90 | $218.78 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $173.78 Typical High $281.84 | Professional | 56 · Pre-op care only | $128.82 | $173.78 | $281.84 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,621.81 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,621.81 | $2,630.27 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,819.70 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,318.26 | $1,819.70 | $2,884.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $134.90 Typical High $288.40 | Professional | 55 · Aftercare only | $100.00 | $134.90 | $288.40 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $173.78 Typical High $371.54 | Professional | 56 · Pre-op care only | $128.82 | $173.78 | $371.54 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,621.81 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,621.81 | $2,570.40 |
Where New York sits
The same service costs 5.2 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· 44th of 51
$2,239
AK $8,710TX $1,660
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.