How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,202 to $14,125Professionalmedian $1,778 · 10th to 90th $1,380 to $3,467
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 $2,089.30 Median $2,089.30 Typical High $3,981.07 | Professional | None | $2,089.30 | $2,089.30 | $3,981.07 |
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 $1,412.54 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,412.54 | $1,698.24 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,071.52 Typical High $2,041.74 | Professional | 62 · Two surgeons | $891.25 | $1,071.52 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $275.42 Typical High $512.86 | Professional | 80 · Assistant surgeon | $229.09 | $275.42 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $239.88 Typical High $446.68 | Professional | AS · PA/NP assist | $199.53 | $239.88 | $446.68 |
CDPHP Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,951.21 | Facility | None | $851.14 | $1,778.28 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,819.70 Typical High $6,309.57 | Professional | None | $1,778.28 | $1,819.70 | $6,309.57 |
Emblem Health Setting Facility Modifier None Typical Low $2,041.74 Median $3,630.78 Typical High $6,918.31 | Facility | None | $2,041.74 | $3,630.78 | $6,918.31 |
Emblem Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $3,801.89 | Professional | None | $1,862.09 | $2,137.96 | $3,801.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,584.89 | $2,398.83 |
MVP Health Care Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
MVP Health Care Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $4,570.88 | Professional | None | $2,951.21 | $2,951.21 | $4,570.88 |
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 $1,412.54 Median $2,041.74 Typical High $5,248.07 | Professional | None | $1,412.54 | $2,041.74 | $5,248.07 |
Univera Setting Facility Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $7,079.46 | Facility | None | $1,230.27 | $1,659.59 | $7,079.46 |
Univera Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,584.89 | $2,398.83 |
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 $1,047.13 Median $1,047.13 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $467.74 | Professional | 53 · Discontinued | $416.87 | $416.87 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $354.81 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $234.42 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,659.59 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,479.11 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,096.48 | $1,479.11 | $2,344.23 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $109.65 Typical High $177.83 | Professional | 55 · Aftercare only | $81.28 | $109.65 | $177.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $141.25 Typical High $223.87 | Professional | 56 · Pre-op care only | $104.71 | $141.25 | $223.87 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,318.26 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $977.24 | $1,318.26 | $2,089.30 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,479.11 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,096.48 | $1,479.11 | $2,344.23 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $109.65 Typical High $239.88 | Professional | 55 · Aftercare only | $81.28 | $109.65 | $239.88 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $141.25 Typical High $302.00 | Professional | 56 · Pre-op care only | $104.71 | $141.25 | $302.00 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,318.26 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $977.24 | $1,318.26 | $2,089.30 |
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· 44th of 51
$1,820
AK $7,079TX $1,288
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.