How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,175 to $13,183Professionalmedian $1,995 · 10th to 90th $1,514 to $3,890
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 $2,290.87 Median $2,290.87 Typical High $4,265.80 | Professional | None | $2,290.87 | $2,290.87 | $4,265.80 |
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 $1,584.89 Median $1,905.46 Typical High $3,630.78 | Professional | None | $1,584.89 | $1,905.46 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,202.26 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,000.00 | $1,202.26 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $302.00 Typical High $575.44 | Professional | 80 · Assistant surgeon | $251.19 | $302.00 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $263.03 Typical High $501.19 | Professional | AS · PA/NP assist | $218.78 | $263.03 | $501.19 |
CDPHP Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,235.94 | Facility | None | $851.14 | $1,778.28 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $7,079.46 | Professional | None | $1,995.26 | $1,995.26 | $7,079.46 |
Emblem Health Setting Facility Modifier None Typical Low $2,238.72 Median $3,981.07 Typical High $7,762.47 | Facility | None | $2,238.72 | $3,981.07 | $7,762.47 |
Emblem Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,344.23 Typical High $4,168.69 | Professional | None | $2,041.74 | $2,344.23 | $4,168.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,737.80 | $2,754.23 |
MVP Health Care Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
MVP Health Care Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $5,011.87 | Professional | None | $3,162.28 | $3,162.28 | $5,011.87 |
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 $1,584.89 Median $2,238.72 Typical High $5,754.40 | Professional | None | $1,584.89 | $2,238.72 | $5,754.40 |
Univera Setting Facility Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $15,488.17 | Facility | None | $1,380.38 | $1,819.70 | $15,488.17 |
Univera Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,737.80 | $2,754.23 |
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 $1,148.15 Median $1,148.15 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $524.81 | Professional | 53 · Discontinued | $467.74 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $263.03 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,819.70 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,621.81 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,202.26 | $1,621.81 | $2,630.27 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $123.03 Typical High $199.53 | Professional | 55 · Aftercare only | $89.13 | $123.03 | $199.53 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $158.49 Typical High $257.04 | Professional | 56 · Pre-op care only | $114.82 | $158.49 | $257.04 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,479.11 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,479.11 | $2,398.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,621.81 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,202.26 | $1,621.81 | $2,570.40 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $123.03 Typical High $263.03 | Professional | 55 · Aftercare only | $89.13 | $123.03 | $263.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $158.49 Typical High $338.84 | Professional | 56 · Pre-op care only | $114.82 | $158.49 | $338.84 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,479.11 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,479.11 | $2,344.23 |
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
$1,995
AK $7,762TX $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.