How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,202 to $14,125Professionalmedian $1,905 · 10th to 90th $1,445 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 $2,137.96 Median $2,137.96 Typical High $4,168.69 | Professional | None | $2,137.96 | $2,137.96 | $4,168.69 |
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 $1,513.56 Median $1,819.70 Typical High $3,388.44 | Professional | None | $1,513.56 | $1,819.70 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,148.15 Typical High $2,238.72 | Professional | 62 · Two surgeons | $954.99 | $1,148.15 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $288.40 Typical High $549.54 | Professional | 80 · Assistant surgeon | $239.88 | $288.40 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $257.04 Typical High $478.63 | Professional | AS · PA/NP assist | $213.80 | $257.04 | $478.63 |
CDPHP Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,090.30 | Facility | None | $851.14 | $1,778.28 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $6,606.93 | Professional | None | $1,905.46 | $1,949.84 | $6,606.93 |
Emblem Health Setting Facility Modifier None Typical Low $2,137.96 Median $3,467.37 Typical High $7,079.46 | Facility | None | $2,137.96 | $3,467.37 | $7,079.46 |
Emblem Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $3,890.45 | Professional | None | $1,949.84 | $2,238.72 | $3,890.45 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,659.59 | $2,630.27 |
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 $2,884.03 Median $2,884.03 Typical High $4,897.79 | Professional | None | $2,884.03 | $2,884.03 | $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 $1,479.11 Median $2,137.96 Typical High $5,623.41 | Professional | None | $1,479.11 | $2,137.96 | $5,623.41 |
Univera Setting Facility Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $9,549.93 | Facility | None | $1,318.26 | $1,737.80 | $9,549.93 |
Univera Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,659.59 | $2,630.27 |
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 $426.58 Median $426.58 Typical High $501.19 | Professional | 53 · Discontinued | $426.58 | $426.58 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $251.19 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,737.80 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,513.56 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,148.15 | $1,513.56 | $2,511.89 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $114.82 Typical High $190.55 | Professional | 55 · Aftercare only | $85.11 | $114.82 | $190.55 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $147.91 Typical High $239.88 | Professional | 56 · Pre-op care only | $109.65 | $147.91 | $239.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,380.38 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,380.38 | $2,238.72 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,548.82 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,148.15 | $1,548.82 | $2,454.71 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $117.49 Typical High $251.19 | Professional | 55 · Aftercare only | $85.11 | $117.49 | $251.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $151.36 Typical High $323.59 | Professional | 56 · Pre-op care only | $109.65 | $151.36 | $323.59 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,412.54 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,412.54 | $2,238.72 |
Where New York sits
The same service costs 6.0 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
$1,905
AK $7,413TX $1,230
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.