How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,175 to $13,183Professionalmedian $1,820 · 10th to 90th $1,413 to $3,631
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 $2,137.96 Median $2,137.96 Typical High $4,073.80 | Professional | None | $2,137.96 | $2,137.96 | $4,073.80 |
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 $1,445.44 Median $1,737.80 Typical High $3,311.31 | Professional | None | $1,445.44 | $1,737.80 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,096.48 Typical High $2,041.74 | Professional | 62 · Two surgeons | $912.01 | $1,096.48 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $281.84 Typical High $524.81 | Professional | 80 · Assistant surgeon | $234.42 | $281.84 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $245.47 Typical High $467.74 | Professional | AS · PA/NP assist | $204.17 | $245.47 | $467.74 |
CDPHP Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,019.95 | Facility | None | $851.14 | $1,778.28 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,862.09 Typical High $6,309.57 | Professional | None | $1,819.70 | $1,862.09 | $6,309.57 |
Emblem Health Setting Facility Modifier None Typical Low $2,041.74 Median $3,630.78 Typical High $7,079.46 | Facility | None | $2,041.74 | $3,630.78 | $7,079.46 |
Emblem Health Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $3,801.89 | Professional | None | $1,862.09 | $2,137.96 | $3,801.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,174.90 | $1,584.89 | $2,454.71 |
MVP Health Care Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
MVP Health Care Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $4,677.35 | Professional | None | $3,019.95 | $3,019.95 | $4,677.35 |
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 $1,445.44 Median $2,089.30 Typical High $5,370.32 | Professional | None | $1,445.44 | $2,089.30 | $5,370.32 |
Univera Setting Facility Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $7,244.36 | Facility | None | $1,258.93 | $1,659.59 | $7,244.36 |
Univera Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,174.90 | $1,584.89 | $2,454.71 |
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 $1,071.52 Median $1,071.52 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,071.52 | $1,071.52 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $478.63 | Professional | 53 · Discontinued | $426.58 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $363.08 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $213.80 Typical High $239.88 | Professional | 56 · Pre-op care only | $213.80 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,513.56 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,513.56 | $1,698.24 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,479.11 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,096.48 | $1,479.11 | $2,398.83 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $112.20 Typical High $177.83 | Professional | 55 · Aftercare only | $83.18 | $112.20 | $177.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $144.54 Typical High $229.09 | Professional | 56 · Pre-op care only | $107.15 | $144.54 | $229.09 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,348.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,348.96 | $2,137.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,479.11 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,096.48 | $1,479.11 | $2,398.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $112.20 Typical High $239.88 | Professional | 55 · Aftercare only | $83.18 | $112.20 | $239.88 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $144.54 Typical High $309.03 | Professional | 56 · Pre-op care only | $107.15 | $144.54 | $309.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,348.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,348.96 | $2,137.96 |
Where New York sits
The same service costs 5.6 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
$1,862
AK $7,244TX $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.