How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,175 to $13,183Professionalmedian $2,399 · 10th to 90th $1,820 to $4,677
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 $2,691.53 Median $2,691.53 Typical High $4,265.80 | Professional | None | $2,691.53 | $2,691.53 | $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 $1,905.46 Median $2,290.87 Typical High $4,466.84 | Professional | None | $1,905.46 | $2,290.87 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,445.44 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,202.26 | $1,445.44 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $363.08 Typical High $707.95 | Professional | 80 · Assistant surgeon | $302.00 | $363.08 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $323.59 Typical High $616.60 | Professional | AS · PA/NP assist | $269.15 | $323.59 | $616.60 |
CDPHP Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,890.45 | Facility | None | $851.14 | $1,778.28 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,454.71 Typical High $8,709.64 | Professional | None | $2,398.83 | $2,454.71 | $8,709.64 |
Emblem Health Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $9,120.11 | Facility | None | $2,691.53 | $4,786.30 | $9,120.11 |
Emblem Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $4,897.79 | Professional | None | $2,454.71 | $2,818.38 | $4,897.79 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,548.82 | $2,041.74 | $3,311.31 |
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 $3,630.78 Median $3,630.78 Typical High $6,165.95 | Professional | None | $3,630.78 | $3,630.78 | $6,165.95 |
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 $1,862.09 Median $2,691.53 Typical High $7,079.46 | Professional | None | $1,862.09 | $2,691.53 | $7,079.46 |
Univera Setting Facility Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $12,022.64 | Facility | None | $1,659.59 | $2,187.76 | $12,022.64 |
Univera Setting Professional Modifier None Typical Low $1,548.82 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,548.82 | $2,041.74 | $3,311.31 |
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 $1,348.96 Median $1,348.96 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,348.96 | $1,348.96 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $537.03 Typical High $630.96 | Professional | 53 · Discontinued | $537.03 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $1,995.26 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,995.26 | $1,995.26 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $398.11 Typical High $467.74 | Professional | 55 · Aftercare only | $398.11 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $269.15 Typical High $316.23 | Professional | 56 · Pre-op care only | $269.15 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,862.09 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,862.09 | $2,187.76 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,905.46 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,445.44 | $1,905.46 | $3,162.28 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $144.54 Typical High $239.88 | Professional | 55 · Aftercare only | $107.15 | $144.54 | $239.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $186.21 Typical High $309.03 | Professional | 56 · Pre-op care only | $138.04 | $186.21 | $309.03 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,737.80 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,737.80 | $2,884.03 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,949.84 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,445.44 | $1,949.84 | $3,090.30 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $147.91 Typical High $316.23 | Professional | 55 · Aftercare only | $107.15 | $147.91 | $316.23 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $190.55 Typical High $407.38 | Professional | 56 · Pre-op care only | $138.04 | $190.55 | $407.38 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,778.28 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,778.28 | $2,818.38 |
Where New York sits
The same service costs 5.8 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
$2,399
AK $9,333TX $1,622
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.