How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,096 to $13,183Professionalmedian $1,549 · 10th to 90th $1,175 to $3,020
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 $1,819.70 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,819.70 | $1,819.70 | $3,467.37 |
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 $1,230.27 Median $1,479.11 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,479.11 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $933.25 Typical High $1,778.28 | Professional | 62 · Two surgeons | $776.25 | $933.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $457.09 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $208.93 Typical High $398.11 | Professional | AS · PA/NP assist | $173.78 | $208.93 | $398.11 |
CDPHP Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,584.89 Typical High $5,370.32 | Professional | None | $1,548.82 | $1,584.89 | $5,370.32 |
Emblem Health Setting Facility Modifier None Typical Low $1,737.80 Median $2,818.38 Typical High $5,754.40 | Facility | None | $1,737.80 | $2,818.38 | $5,754.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,621.81 | $1,819.70 | $3,019.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,348.96 | $2,187.76 |
MVP Health Care Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
MVP Health Care Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,981.07 | Professional | None | $2,691.53 | $2,691.53 | $3,981.07 |
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 $1,230.27 Median $1,778.28 Typical High $4,570.88 | Professional | None | $1,230.27 | $1,778.28 | $4,570.88 |
Univera Setting Facility Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $11,481.54 | Facility | None | $1,071.52 | $1,412.54 | $11,481.54 |
Univera Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,348.96 | $2,187.76 |
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 $912.01 Median $912.01 Typical High $1,023.29 | Professional | 52 · Reduced service | $912.01 | $912.01 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $407.38 | Professional | 53 · Discontinued | $363.08 | $363.08 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $302.00 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $204.17 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,412.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,258.93 Typical High $2,089.30 | Professional | 54 · Surgery only | $933.25 | $1,258.93 | $2,089.30 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $95.50 Typical High $154.88 | Professional | 55 · Aftercare only | $70.79 | $95.50 | $154.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $123.03 Typical High $199.53 | Professional | 56 · Pre-op care only | $91.20 | $123.03 | $199.53 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,148.15 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $851.14 | $1,148.15 | $1,862.09 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,288.25 Typical High $1,995.26 | Professional | 54 · Surgery only | $933.25 | $1,288.25 | $1,995.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $95.50 Typical High $204.17 | Professional | 55 · Aftercare only | $70.79 | $95.50 | $204.17 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $123.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $91.20 | $123.03 | $263.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,148.15 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $851.14 | $1,148.15 | $1,819.70 |
Where New York sits
The same service costs 5.9 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· 43rd of 51
$1,585
AK $6,166TX $1,047
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.