How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,288 to $10,000Professionalmedian $977 · 10th to 90th $741 to $1,950
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 $1,174.90 Median $1,174.90 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,174.90 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,819.70 | Professional | None | $776.25 | $933.25 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $588.84 Typical High $1,148.15 | Professional | 62 · Two surgeons | $489.78 | $588.84 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $147.91 Typical High $288.40 | Professional | 80 · Assistant surgeon | $123.03 | $147.91 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $131.83 Typical High $257.04 | Professional | AS · PA/NP assist | $107.15 | $131.83 | $257.04 |
CDPHP Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $6,165.95 | Facility | None | $2,089.30 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $5,495.41 | Facility | None | $1,584.89 | $2,754.23 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $3,548.13 | Professional | None | $1,000.00 | $1,047.13 | $3,548.13 |
Emblem Health Setting Facility Modifier None Typical Low $954.99 Median $1,737.80 Typical High $3,548.13 | Facility | None | $954.99 | $1,737.80 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,122.02 | $1,995.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,348.96 | Professional | None | $630.96 | $831.76 | $1,348.96 |
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 $1,071.52 Median $1,071.52 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,071.52 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,332.54 | Facility | None | $1,230.27 | $3,162.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $2,884.03 | Professional | None | $758.58 | $1,122.02 | $2,884.03 |
Univera Setting Facility Modifier None Typical Low $676.08 Median $691.83 Typical High $3,548.13 | Facility | None | $676.08 | $691.83 | $3,548.13 |
Univera Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,348.96 | Professional | None | $630.96 | $831.76 | $1,348.96 |
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 $588.84 Median $588.84 Typical High $630.96 | Professional | 52 · Reduced service | $588.84 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $257.04 | Professional | 53 · Discontinued | $239.88 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $954.99 | Professional | 54 · Surgery only | $891.25 | $891.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $190.55 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $128.82 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $891.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $776.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $588.84 | $776.25 | $1,288.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $57.54 Typical High $97.72 | Professional | 55 · Aftercare only | $43.65 | $57.54 | $97.72 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $74.13 Typical High $125.89 | Professional | 56 · Pre-op care only | $56.23 | $74.13 | $125.89 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $691.83 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $524.81 | $691.83 | $1,174.90 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $776.25 Typical High $1,258.93 | Professional | 54 · Surgery only | $588.84 | $776.25 | $1,258.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $60.26 Typical High $128.82 | Professional | 55 · Aftercare only | $43.65 | $60.26 | $128.82 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $77.62 Typical High $165.96 | Professional | 56 · Pre-op care only | $56.23 | $77.62 | $165.96 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $691.83 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $524.81 | $691.83 | $1,148.15 |
Where New York sits
The same service costs 4.6 times more in Wisconsin 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· 49th of 51
$1,000
WI $3,981TX $871
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.