How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,096 to $13,183Professionalmedian $1,349 · 10th to 90th $1,023 to $2,630
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 $1,513.56 Median $1,513.56 Typical High $3,019.95 | Professional | None | $1,513.56 | $1,513.56 | $3,019.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $7,413.10 Typical High $14,454.40 | Facility | None | $1,659.59 | $7,413.10 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,454.71 | Professional | None | $1,071.52 | $1,288.25 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $812.83 Typical High $1,513.56 | Professional | 62 · Two surgeons | $676.08 | $812.83 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $204.17 Typical High $389.05 | Professional | 80 · Assistant surgeon | $169.82 | $204.17 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $181.97 Typical High $338.84 | Professional | AS · PA/NP assist | $151.36 | $181.97 | $338.84 |
CDPHP Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $4,786.30 | Professional | None | $1,348.96 | $1,380.38 | $4,786.30 |
Emblem Health Setting Facility Modifier None Typical Low $1,513.56 Median $2,089.30 Typical High $4,897.79 | Facility | None | $1,513.56 | $2,089.30 | $4,897.79 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,621.81 | $2,818.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,819.70 | Professional | None | $870.96 | $1,174.90 | $1,819.70 |
MVP Health Care Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
MVP Health Care Setting Professional Modifier None Typical Low $2,454.71 Median $2,511.89 Typical High $3,467.37 | Professional | None | $2,454.71 | $2,511.89 | $3,467.37 |
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 $1,071.52 Median $1,548.82 Typical High $3,981.07 | Professional | None | $1,071.52 | $1,548.82 | $3,981.07 |
Univera Setting Facility Modifier None Typical Low $933.25 Median $1,230.27 Typical High $5,754.40 | Facility | None | $933.25 | $1,230.27 | $5,754.40 |
Univera Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,819.70 | Professional | None | $870.96 | $1,174.90 | $1,819.70 |
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 $758.58 Median $758.58 Typical High $891.25 | Professional | 52 · Reduced service | $758.58 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $354.81 | Professional | 53 · Discontinued | $302.00 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $263.03 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,230.27 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,096.48 Typical High $1,737.80 | Professional | 54 · Surgery only | $812.83 | $1,096.48 | $1,737.80 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $83.18 Typical High $131.83 | Professional | 55 · Aftercare only | $61.66 | $83.18 | $131.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $107.15 Typical High $169.82 | Professional | 56 · Pre-op care only | $79.43 | $107.15 | $169.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,000.00 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $741.31 | $1,000.00 | $1,584.89 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,096.48 Typical High $1,737.80 | Professional | 54 · Surgery only | $812.83 | $1,096.48 | $1,737.80 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $83.18 Typical High $177.83 | Professional | 55 · Aftercare only | $61.66 | $83.18 | $177.83 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $107.15 Typical High $229.09 | Professional | 56 · Pre-op care only | $79.43 | $107.15 | $229.09 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,000.00 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $741.31 | $1,000.00 | $1,584.89 |
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· 43rd of 51
$1,380
AK $5,370TX $912
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.