How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,072 to $10,965Professionalmedian $1,349 · 10th to 90th $1,023 to $2,630
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,737.80 | $1,737.80 | $3,019.95 |
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 $1,071.52 Median $1,288.25 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,288.25 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $812.83 Typical High $1,513.56 | Professional | 62 · Two surgeons | $676.08 | $812.83 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $204.17 Typical High $389.05 | Professional | 80 · Assistant surgeon | $169.82 | $204.17 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $177.83 Typical High $338.84 | Professional | AS · PA/NP assist | $147.91 | $177.83 | $338.84 |
CDPHP Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $1,380.38 Median $1,445.44 Typical High $4,786.30 | Professional | None | $1,380.38 | $1,445.44 | $4,786.30 |
Emblem Health Setting Facility Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $4,786.30 | Facility | None | $1,318.26 | $1,905.46 | $4,786.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,754.23 | Professional | None | $1,348.96 | $1,548.82 | $2,754.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,778.28 | Professional | None | $870.96 | $1,148.15 | $1,778.28 |
MVP Health Care Setting Facility Modifier None Typical Low $1,513.56 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,513.56 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $3,467.37 | Professional | None | $1,479.11 | $1,479.11 | $3,467.37 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,165.95 | Facility | None | $575.44 | $1,778.28 | $6,165.95 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,548.82 Typical High $3,981.07 | Professional | None | $1,023.29 | $1,548.82 | $3,981.07 |
Univera Setting Facility Modifier None Typical Low $912.01 Median $1,230.27 Typical High $5,754.40 | Facility | None | $912.01 | $1,230.27 | $5,754.40 |
Univera Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,778.28 | Professional | None | $870.96 | $1,148.15 | $1,778.28 |
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 $870.96 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $870.96 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $354.81 | Professional | 53 · Discontinued | $346.74 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $263.03 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,230.27 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,047.13 Typical High $1,737.80 | Professional | 54 · Surgery only | $812.83 | $1,047.13 | $1,737.80 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $79.43 Typical High $131.83 | Professional | 55 · Aftercare only | $60.26 | $79.43 | $131.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $102.33 Typical High $165.96 | Professional | 56 · Pre-op care only | $77.62 | $102.33 | $165.96 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $954.99 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $724.44 | $954.99 | $1,548.82 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,047.13 Typical High $1,737.80 | Professional | 54 · Surgery only | $812.83 | $1,047.13 | $1,737.80 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $83.18 Typical High $173.78 | Professional | 55 · Aftercare only | $60.26 | $83.18 | $173.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $107.15 Typical High $223.87 | Professional | 56 · Pre-op care only | $77.62 | $107.15 | $223.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,000.00 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $724.44 | $1,000.00 | $1,548.82 |
Where New York sits
The same service costs 4.9 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· 46th of 51
$1,380
AK $5,248TX $1,072
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.