How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,175 to $13,183Professionalmedian $2,138 · 10th to 90th $1,622 to $4,169
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 $2,511.89 Median $2,511.89 Typical High $3,715.35 | Professional | None | $2,511.89 | $2,511.89 | $3,715.35 |
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 $1,698.24 Median $2,041.74 Typical High $3,890.45 | Professional | None | $1,698.24 | $2,041.74 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,288.25 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,071.52 | $1,288.25 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $331.13 Typical High $616.60 | Professional | 80 · Assistant surgeon | $269.15 | $331.13 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $288.40 Typical High $549.54 | Professional | AS · PA/NP assist | $239.88 | $288.40 | $549.54 |
CDPHP Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,467.37 | Facility | None | $851.14 | $1,778.28 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,187.76 Typical High $7,585.78 | Professional | None | $2,137.96 | $2,187.76 | $7,585.78 |
Emblem Health Setting Facility Modifier None Typical Low $2,398.83 Median $4,073.80 Typical High $8,128.31 | Facility | None | $2,398.83 | $4,073.80 | $8,128.31 |
Emblem Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $4,365.16 | Professional | None | $2,187.76 | $2,511.89 | $4,365.16 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,862.09 | $2,884.03 |
MVP Health Care Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
MVP Health Care Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $5,495.41 | Professional | None | $3,311.31 | $3,311.31 | $5,495.41 |
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 $1,659.59 Median $2,398.83 Typical High $6,309.57 | Professional | None | $1,659.59 | $2,398.83 | $6,309.57 |
Univera Setting Facility Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $8,317.64 | Facility | None | $1,479.11 | $1,949.84 | $8,317.64 |
Univera Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,862.09 | $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 $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $501.19 Typical High $562.34 | Professional | 53 · Discontinued | $501.19 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,905.46 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,905.46 | $1,905.46 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $380.19 Typical High $416.87 | Professional | 55 · Aftercare only | $380.19 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $281.84 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,778.28 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,778.28 | $1,949.84 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,698.24 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,288.25 | $1,698.24 | $2,691.53 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $128.82 Typical High $199.53 | Professional | 55 · Aftercare only | $97.72 | $128.82 | $199.53 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $165.96 Typical High $257.04 | Professional | 56 · Pre-op care only | $123.03 | $165.96 | $257.04 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,548.82 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,548.82 | $2,398.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,698.24 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,288.25 | $1,698.24 | $2,691.53 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $131.83 Typical High $281.84 | Professional | 55 · Aftercare only | $97.72 | $131.83 | $281.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $169.82 Typical High $363.08 | Professional | 56 · Pre-op care only | $123.03 | $169.82 | $363.08 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,584.89 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,584.89 | $2,398.83 |
Where New York sits
The same service costs 5.4 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
$2,138
AK $8,318TX $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.