How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,175 to $13,183Professionalmedian $2,291 · 10th to 90th $1,778 to $4,467
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 $2,570.40 Median $2,570.40 Typical High $3,981.07 | Professional | None | $2,570.40 | $2,570.40 | $3,981.07 |
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 $1,819.70 Median $2,187.76 Typical High $4,168.69 | Professional | None | $1,819.70 | $2,187.76 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,380.38 Typical High $2,630.27 | Professional | 62 · Two surgeons | $1,148.15 | $1,380.38 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $354.81 Typical High $660.69 | Professional | 80 · Assistant surgeon | $295.12 | $354.81 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $309.03 Typical High $575.44 | Professional | AS · PA/NP assist | $257.04 | $309.03 | $575.44 |
CDPHP Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,715.35 | Facility | None | $851.14 | $1,778.28 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,344.23 Typical High $8,128.31 | Professional | None | $2,290.87 | $2,344.23 | $8,128.31 |
Emblem Health Setting Facility Modifier None Typical Low $2,570.40 Median $4,365.16 Typical High $8,709.64 | Facility | None | $2,570.40 | $4,365.16 | $8,709.64 |
Emblem Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $4,466.84 | Professional | None | $2,344.23 | $2,691.53 | $4,466.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,479.11 | $1,995.26 | $3,235.94 |
MVP Health Care Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Facility | None | $2,454.71 | $2,454.71 | $2,454.71 |
MVP Health Care Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $5,888.44 | Professional | None | $3,467.37 | $3,467.37 | $5,888.44 |
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 $1,778.28 Median $2,630.27 Typical High $6,760.83 | Professional | None | $1,778.28 | $2,630.27 | $6,760.83 |
Univera Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $11,481.54 | Facility | None | $1,584.89 | $2,089.30 | $11,481.54 |
Univera Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,479.11 | $1,995.26 | $3,235.94 |
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 $1,288.25 Median $1,288.25 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $512.86 Typical High $602.56 | Professional | 53 · Discontinued | $512.86 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $457.09 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | 56 · Pre-op care only | $257.04 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $2,089.30 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,862.09 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,380.38 | $1,862.09 | $3,019.95 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $138.04 Typical High $229.09 | Professional | 55 · Aftercare only | $104.71 | $138.04 | $229.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $177.83 Typical High $295.12 | Professional | 56 · Pre-op care only | $134.90 | $177.83 | $295.12 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,659.59 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,659.59 | $2,754.23 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,905.46 Typical High $2,951.21 | Professional | 54 · Surgery only | $1,380.38 | $1,905.46 | $2,951.21 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $141.25 Typical High $302.00 | Professional | 55 · Aftercare only | $104.71 | $141.25 | $302.00 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $181.97 Typical High $389.05 | Professional | 56 · Pre-op care only | $134.90 | $181.97 | $389.05 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,698.24 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,698.24 | $2,691.53 |
Where New York sits
The same service costs 6.2 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
$2,344
AK $9,120TX $1,479
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.