How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,202 to $14,125Professionalmedian $2,754 · 10th to 90th $2,138 to $5,248
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 $3,090.30 Median $3,090.30 Typical High $4,466.84 | Professional | None | $3,090.30 | $3,090.30 | $4,466.84 |
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 $2,238.72 Median $2,691.53 Typical High $4,897.79 | Professional | None | $2,238.72 | $2,691.53 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $426.58 Typical High $776.25 | Professional | 80 · Assistant surgeon | $354.81 | $426.58 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $380.19 Typical High $676.08 | Professional | AS · PA/NP assist | $316.23 | $380.19 | $676.08 |
CDPHP Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $4,466.84 | Facility | None | $851.14 | $1,778.28 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $9,549.93 | Professional | None | $2,754.23 | $2,754.23 | $9,549.93 |
Emblem Health Setting Facility Modifier None Typical Low $3,090.30 Median $4,073.80 Typical High $10,000.00 | Facility | None | $3,090.30 | $4,073.80 | $10,000.00 |
Emblem Health Setting Professional Modifier None Typical Low $2,818.38 Median $3,235.94 Typical High $5,370.32 | Professional | None | $2,818.38 | $3,235.94 | $5,370.32 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,778.28 | $2,398.83 | $3,630.78 |
MVP Health Care Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
MVP Health Care Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $6,918.31 | Professional | None | $3,715.35 | $3,715.35 | $6,918.31 |
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 $2,137.96 Median $3,090.30 Typical High $7,943.28 | Professional | None | $2,137.96 | $3,090.30 | $7,943.28 |
Univera Setting Facility Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $11,220.18 | Facility | None | $1,862.09 | $2,511.89 | $11,220.18 |
Univera Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,778.28 | $2,398.83 | $3,630.78 |
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 $1,548.82 Median $1,548.82 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,548.82 | $1,548.82 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | 53 · Discontinued | $616.60 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,290.87 Median $2,290.87 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,290.87 | $2,290.87 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $457.09 Typical High $537.03 | Professional | 55 · Aftercare only | $457.09 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $309.03 Typical High $354.81 | Professional | 56 · Pre-op care only | $309.03 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,137.96 Median $2,137.96 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,137.96 | $2,137.96 | $2,511.89 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,238.72 Typical High $3,548.13 | Professional | 54 · Surgery only | $1,621.81 | $2,238.72 | $3,548.13 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $165.96 Typical High $263.03 | Professional | 55 · Aftercare only | $123.03 | $165.96 | $263.03 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $213.80 Typical High $338.84 | Professional | 56 · Pre-op care only | $158.49 | $213.80 | $338.84 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,995.26 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,995.26 | $3,162.28 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,238.72 Typical High $3,548.13 | Professional | 54 · Surgery only | $1,621.81 | $2,238.72 | $3,548.13 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $169.82 Typical High $354.81 | Professional | 55 · Aftercare only | $123.03 | $169.82 | $354.81 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $218.78 Typical High $457.09 | Professional | 56 · Pre-op care only | $158.49 | $218.78 | $457.09 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $2,041.74 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $1,479.11 | $2,041.74 | $3,162.28 |
Where New York sits
The same service costs 6.9 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· 40th of 51
$2,818
AK $10,715TX $1,549
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.