How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,047 to $9,772Professionalmedian $1,738 · 10th to 90th $1,380 to $3,548
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 $1,995.26 Median $1,995.26 Typical High $3,981.07 | Professional | None | $1,995.26 | $1,995.26 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $4,365.16 Typical High $10,715.19 | Facility | None | $1,445.44 | $4,365.16 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $3,235.94 | Professional | None | $1,445.44 | $1,737.80 | $3,235.94 |
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 $229.09 Median $275.42 Typical High $512.86 | Professional | 80 · Assistant surgeon | $229.09 | $275.42 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $239.88 Typical High $457.09 | Professional | AS · PA/NP assist | $199.53 | $239.88 | $457.09 |
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 $2,951.21 | Facility | None | $851.14 | $1,778.28 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $6,165.95 | Professional | None | $1,819.70 | $1,819.70 | $6,165.95 |
Emblem Health Setting Facility Modifier None Typical Low $1,819.70 Median $2,511.89 Typical High $6,606.93 | Facility | None | $1,819.70 | $2,511.89 | $6,606.93 |
Emblem Health Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $3,801.89 | Professional | None | $1,995.26 | $2,137.96 | $3,801.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,584.89 | $2,511.89 |
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 $1,479.11 Median $1,479.11 Typical High $4,570.88 | Professional | None | $1,479.11 | $1,479.11 | $4,570.88 |
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 $1,445.44 Median $2,041.74 Typical High $5,248.07 | Professional | None | $1,445.44 | $2,041.74 | $5,248.07 |
Univera Setting Facility Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $5,754.40 | Facility | None | $1,258.93 | $1,288.25 | $5,754.40 |
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 $1,000.00 Median $1,000.00 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $478.63 | Professional | 53 · Discontinued | $407.38 | $407.38 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $354.81 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,659.59 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,479.11 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,096.48 | $1,479.11 | $2,344.23 |
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 $104.71 Median $144.54 Typical High $229.09 | Professional | 56 · Pre-op care only | $104.71 | $144.54 | $229.09 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,348.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $977.24 | $1,348.96 | $2,137.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,479.11 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,096.48 | $1,479.11 | $2,344.23 |
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 $104.71 Median $144.54 Typical High $309.03 | Professional | 56 · Pre-op care only | $104.71 | $144.54 | $309.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,348.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $977.24 | $1,348.96 | $2,137.96 |
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· 42nd of 51
$1,820
AK $7,079TX $1,230
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.