How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,175 to $10,965Professionalmedian $1,660 · 10th to 90th $1,318 to $3,388
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 $1,949.84 Median $1,949.84 Typical High $3,801.89 | Professional | None | $1,949.84 | $1,949.84 | $3,801.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $3,090.30 | Professional | None | $1,380.38 | $1,659.59 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,047.13 Typical High $1,949.84 | Professional | 62 · Two surgeons | $870.96 | $1,047.13 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $263.03 Typical High $501.19 | Professional | 80 · Assistant surgeon | $218.78 | $263.03 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $229.09 Typical High $436.52 | Professional | AS · PA/NP assist | $190.55 | $229.09 | $436.52 |
CDPHP Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,818.38 | Facility | None | $851.14 | $1,778.28 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $6,025.60 | Professional | None | $1,737.80 | $1,778.28 | $6,025.60 |
Emblem Health Setting Facility Modifier None Typical Low $1,949.84 Median $3,311.31 Typical High $6,606.93 | Facility | None | $1,949.84 | $3,311.31 | $6,606.93 |
Emblem Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $3,630.78 | Professional | None | $1,621.81 | $2,041.74 | $3,630.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,513.56 | $2,398.83 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,786.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $4,466.84 | Professional | None | $1,445.44 | $1,445.44 | $4,466.84 |
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 $1,348.96 Median $1,949.84 Typical High $5,128.61 | Professional | None | $1,348.96 | $1,949.84 | $5,128.61 |
Univera Setting Facility Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $5,754.40 | Facility | None | $1,202.26 | $1,230.27 | $5,754.40 |
Univera Setting Professional Modifier None Typical Low $1,122.02 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,513.56 | $2,398.83 |
9 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 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $1,584.89 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,412.54 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,047.13 | $1,412.54 | $2,290.87 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $104.71 Typical High $173.78 | Professional | 55 · Aftercare only | $77.62 | $104.71 | $173.78 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $134.90 Typical High $223.87 | Professional | 56 · Pre-op care only | $100.00 | $134.90 | $223.87 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,258.93 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $933.25 | $1,258.93 | $2,089.30 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,412.54 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,047.13 | $1,412.54 | $2,238.72 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $107.15 Typical High $229.09 | Professional | 55 · Aftercare only | $77.62 | $107.15 | $229.09 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $138.04 Typical High $295.12 | Professional | 56 · Pre-op care only | $100.00 | $138.04 | $295.12 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,258.93 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $933.25 | $1,258.93 | $2,041.74 |
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
$1,738
AK $6,761TX $1,202
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.