How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,175 to $12,303Professionalmedian $3,548 · 10th to 90th $2,692 to $6,761
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 $4,168.69 Median $4,168.69 Typical High $5,754.40 | Professional | None | $4,168.69 | $4,168.69 | $5,754.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,778.28 | $6,760.83 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,818.38 Median $3,388.44 Typical High $6,309.57 | Professional | None | $2,818.38 | $3,388.44 | $6,309.57 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $446.68 Median $537.03 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $446.68 | $537.03 | $1,000.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $467.74 Typical High $870.96 | Professional | AS · PA/NP assist | $389.05 | $467.74 | $870.96 |
CDPHP Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $16,595.87 | Facility | None | $5,495.41 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $5,754.40 | Facility | None | $851.14 | $1,778.28 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $12,022.64 | Professional | None | $3,548.13 | $3,548.13 | $12,022.64 |
Emblem Health Setting Facility Modifier None Typical Low $3,630.78 Median $6,606.93 Typical High $13,182.57 | Facility | None | $3,630.78 | $6,606.93 | $13,182.57 |
Emblem Health Setting Professional Modifier None Typical Low $3,548.13 Median $4,073.80 Typical High $7,244.36 | Professional | None | $3,548.13 | $4,073.80 | $7,244.36 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,290.87 Median $3,019.95 Typical High $4,897.79 | Professional | None | $2,290.87 | $3,019.95 | $4,897.79 |
MVP Health Care Setting Facility Modifier None Typical Low $3,890.45 Median $4,786.30 Typical High $5,754.40 | Facility | None | $3,890.45 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $8,912.51 | Professional | None | $4,786.30 | $4,786.30 | $8,912.51 |
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 $2,754.23 Median $3,890.45 Typical High $10,471.29 | Professional | None | $2,754.23 | $3,890.45 | $10,471.29 |
Univera Setting Facility Modifier None Typical Low $2,398.83 Median $3,235.94 Typical High $9,120.11 | Facility | None | $2,398.83 | $3,235.94 | $9,120.11 |
Univera Setting Professional Modifier None Typical Low $2,290.87 Median $3,019.95 Typical High $4,897.79 | Professional | None | $2,290.87 | $3,019.95 | $4,897.79 |
12 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 $2,089.30 Median $2,089.30 Typical High $2,290.87 | Professional | 52 · Reduced service | $2,089.30 | $2,089.30 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $831.76 Typical High $912.01 | Professional | 53 · Discontinued | $831.76 | $831.76 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,090.30 Median $3,090.30 Typical High $3,467.37 | Professional | 54 · Surgery only | $3,090.30 | $3,090.30 | $3,467.37 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $2,884.03 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,884.03 | $2,884.03 | $3,235.94 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,818.38 Typical High $4,677.35 | Professional | 54 · Surgery only | $2,089.30 | $2,818.38 | $4,677.35 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $213.80 Typical High $346.74 | Professional | 55 · Aftercare only | $158.49 | $213.80 | $346.74 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $269.15 Typical High $446.68 | Professional | 56 · Pre-op care only | $204.17 | $269.15 | $446.68 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,511.89 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,511.89 | $4,168.69 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,884.03 Typical High $4,570.88 | Professional | 54 · Surgery only | $2,089.30 | $2,884.03 | $4,570.88 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $218.78 Typical High $457.09 | Professional | 55 · Aftercare only | $158.49 | $218.78 | $457.09 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $281.84 Typical High $588.84 | Professional | 56 · Pre-op care only | $204.17 | $281.84 | $588.84 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,630.27 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,630.27 | $4,073.80 |
Where New York sits
The same service costs 7.6 times more in Alaska than in Arkansas. 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· 42nd of 51
$3,548
AK $13,804AR $1,820
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.