How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,175 to $10,965Professionalmedian $2,344 · 10th to 90th $1,862 to $4,786
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 $2,884.03 Median $2,884.03 Typical High $4,265.80 | Professional | None | $2,884.03 | $2,884.03 | $4,265.80 |
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 $1,949.84 Median $2,344.23 Typical High $4,365.16 | Professional | None | $1,949.84 | $2,344.23 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,479.11 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,230.27 | $1,479.11 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $371.54 Typical High $707.95 | Professional | 80 · Assistant surgeon | $309.03 | $371.54 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $323.59 Typical High $616.60 | Professional | AS · PA/NP assist | $269.15 | $323.59 | $616.60 |
CDPHP Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,981.07 | Facility | None | $851.14 | $1,778.28 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,511.89 Typical High $8,511.38 | Professional | None | $2,454.71 | $2,511.89 | $8,511.38 |
Emblem Health Setting Facility Modifier None Typical Low $2,691.53 Median $4,466.84 Typical High $9,120.11 | Facility | None | $2,691.53 | $4,466.84 | $9,120.11 |
Emblem Health Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $5,011.87 | Professional | None | $2,454.71 | $2,884.03 | $5,011.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $3,235.94 | Professional | None | $1,584.89 | $2,089.30 | $3,235.94 |
MVP Health Care Setting Facility Modifier None Typical Low $2,630.27 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,630.27 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $6,165.95 | Professional | None | $1,949.84 | $1,949.84 | $6,165.95 |
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 $1,905.46 Median $2,754.23 Typical High $7,244.36 | Professional | None | $1,905.46 | $2,754.23 | $7,244.36 |
Univera Setting Facility Modifier None Typical Low $1,659.59 Median $2,238.72 Typical High $7,943.28 | Facility | None | $1,659.59 | $2,238.72 | $7,943.28 |
Univera Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $3,235.94 | Professional | None | $1,584.89 | $2,089.30 | $3,235.94 |
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 $1,995.26 Median $1,995.26 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,995.26 | $1,995.26 | $2,238.72 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,949.84 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,479.11 | $1,949.84 | $3,162.28 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $147.91 Typical High $239.88 | Professional | 55 · Aftercare only | $109.65 | $147.91 | $239.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $190.55 Typical High $309.03 | Professional | 56 · Pre-op care only | $141.25 | $190.55 | $309.03 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,778.28 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,778.28 | $2,884.03 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,949.84 Typical High $3,162.28 | Professional | 54 · Surgery only | $1,479.11 | $1,949.84 | $3,162.28 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $151.36 Typical High $323.59 | Professional | 55 · Aftercare only | $109.65 | $151.36 | $323.59 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $194.98 Typical High $407.38 | Professional | 56 · Pre-op care only | $141.25 | $194.98 | $407.38 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,819.70 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,819.70 | $2,884.03 |
Where New York sits
The same service costs 5.8 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
$2,455
AK $9,550TX $1,660
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.