How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,202 to $14,125Professionalmedian $2,089 · 10th to 90th $1,585 to $3,981
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 $4,265.80 | Professional | None | $2,454.71 | $2,454.71 | $4,265.80 |
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 $1,659.59 Median $1,995.26 Typical High $3,715.35 | Professional | None | $1,659.59 | $1,995.26 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $316.23 Typical High $588.84 | Professional | 80 · Assistant surgeon | $263.03 | $316.23 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $275.42 Typical High $512.86 | Professional | AS · PA/NP assist | $229.09 | $275.42 | $512.86 |
CDPHP Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,388.44 | Facility | None | $851.14 | $1,778.28 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $7,244.36 | Professional | None | $2,089.30 | $2,089.30 | $7,244.36 |
Emblem Health Setting Facility Modifier None Typical Low $2,344.23 Median $3,630.78 Typical High $7,585.78 | Facility | None | $2,344.23 | $3,630.78 | $7,585.78 |
Emblem Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,454.71 Typical High $4,265.80 | Professional | None | $2,137.96 | $2,454.71 | $4,265.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,778.28 | $2,884.03 |
MVP Health Care Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Facility | None | $2,511.89 | $2,511.89 | $2,511.89 |
MVP Health Care Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $5,248.07 | Professional | None | $2,818.38 | $2,818.38 | $5,248.07 |
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 $1,621.81 Median $2,344.23 Typical High $6,025.60 | Professional | None | $1,621.81 | $2,344.23 | $6,025.60 |
Univera Setting Facility Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $9,549.93 | Facility | None | $1,412.54 | $1,905.46 | $9,549.93 |
Univera Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,778.28 | $2,884.03 |
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 $1,348.96 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $549.54 | Professional | 53 · Discontinued | $489.78 | $489.78 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $407.38 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $269.15 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $1,905.46 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,659.59 Typical High $2,754.23 | Professional | 54 · Surgery only | $1,258.93 | $1,659.59 | $2,754.23 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $125.89 Typical High $208.93 | Professional | 55 · Aftercare only | $93.33 | $125.89 | $208.93 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $162.18 Typical High $269.15 | Professional | 56 · Pre-op care only | $120.23 | $162.18 | $269.15 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,513.56 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,513.56 | $2,511.89 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,698.24 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,258.93 | $1,698.24 | $2,691.53 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $128.82 Typical High $275.42 | Professional | 55 · Aftercare only | $93.33 | $128.82 | $275.42 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $165.96 Typical High $346.74 | Professional | 56 · Pre-op care only | $120.23 | $165.96 | $346.74 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,548.82 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,548.82 | $2,398.83 |
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· 46th of 51
$2,089
AK $8,128TX $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.