How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,202 to $14,125Professionalmedian $1,950 · 10th to 90th $1,479 to $3,715
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 $2,187.76 Median $2,187.76 Typical High $3,235.94 | Professional | None | $2,187.76 | $2,187.76 | $3,235.94 |
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 $1,548.82 Median $1,862.09 Typical High $3,467.37 | Professional | None | $1,548.82 | $1,862.09 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,174.90 Typical High $2,187.76 | Professional | 62 · Two surgeons | $977.24 | $1,174.90 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $295.12 Typical High $549.54 | Professional | 80 · Assistant surgeon | $245.47 | $295.12 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $257.04 Typical High $489.78 | Professional | AS · PA/NP assist | $213.80 | $257.04 | $489.78 |
CDPHP Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,162.28 | Facility | None | $851.14 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $6,760.83 | Professional | None | $1,949.84 | $1,949.84 | $6,760.83 |
Emblem Health Setting Facility Modifier None Typical Low $2,187.76 Median $3,548.13 Typical High $7,244.36 | Facility | None | $2,187.76 | $3,548.13 | $7,244.36 |
Emblem Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $3,981.07 | Professional | None | $1,995.26 | $2,290.87 | $3,981.07 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,698.24 | $2,570.40 |
MVP Health Care Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
MVP Health Care Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $4,897.79 | Professional | None | $3,090.30 | $3,090.30 | $4,897.79 |
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 $1,513.56 Median $2,187.76 Typical High $5,623.41 | Professional | None | $1,513.56 | $2,187.76 | $5,623.41 |
Univera Setting Facility Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $9,549.93 | Facility | None | $1,318.26 | $1,778.28 | $9,549.93 |
Univera Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,258.93 | $1,698.24 | $2,570.40 |
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 $1,071.52 Median $1,071.52 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $501.19 | Professional | 53 · Discontinued | $436.52 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $380.19 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $251.19 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,513.56 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,513.56 | $1,778.28 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,548.82 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,174.90 | $1,548.82 | $2,511.89 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $117.49 Typical High $190.55 | Professional | 55 · Aftercare only | $87.10 | $117.49 | $190.55 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $151.36 Typical High $239.88 | Professional | 56 · Pre-op care only | $112.20 | $151.36 | $239.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,412.54 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,412.54 | $2,238.72 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,548.82 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,174.90 | $1,548.82 | $2,398.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $120.23 Typical High $257.04 | Professional | 55 · Aftercare only | $87.10 | $120.23 | $257.04 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $154.88 Typical High $323.59 | Professional | 56 · Pre-op care only | $112.20 | $154.88 | $323.59 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,445.44 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,445.44 | $2,187.76 |
Where New York sits
The same service costs 5.9 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· 44th of 51
$1,950
AK $7,586TX $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.