How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,047 to $9,772Professionalmedian $1,549 · 10th to 90th $1,175 to $2,951
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 $1,737.80 Median $1,737.80 Typical High $3,388.44 | Professional | None | $1,737.80 | $1,737.80 | $3,388.44 |
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 $1,202.26 Median $1,445.44 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,445.44 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $912.01 Typical High $1,778.28 | Professional | 62 · Two surgeons | $758.58 | $912.01 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $446.68 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $204.17 Typical High $389.05 | Professional | AS · PA/NP assist | $169.82 | $204.17 | $389.05 |
CDPHP Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $1,548.82 Median $1,548.82 Typical High $5,495.41 | Professional | None | $1,548.82 | $1,548.82 | $5,495.41 |
Emblem Health Setting Facility Modifier None Typical Low $1,479.11 Median $2,454.71 Typical High $5,370.32 | Facility | None | $1,479.11 | $2,454.71 | $5,370.32 |
Emblem Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,621.81 | $1,778.28 | $3,090.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $2,137.96 | Professional | None | $977.24 | $1,288.25 | $2,137.96 |
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 $1,548.82 Median $1,548.82 Typical High $3,890.45 | Professional | None | $1,548.82 | $1,548.82 | $3,890.45 |
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 $1,174.90 Median $1,698.24 Typical High $4,466.84 | Professional | None | $1,174.90 | $1,698.24 | $4,466.84 |
Univera Setting Facility Modifier None Typical Low $1,047.13 Median $1,096.48 Typical High $5,370.32 | Facility | None | $1,047.13 | $1,096.48 | $5,370.32 |
Univera Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $2,137.96 | Professional | None | $977.24 | $1,288.25 | $2,137.96 |
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 $870.96 Median $870.96 Typical High $1,000.00 | Professional | 52 · Reduced service | $870.96 | $870.96 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $398.11 | Professional | 53 · Discontinued | $346.74 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $302.00 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,380.38 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,202.26 Typical High $2,041.74 | Professional | 54 · Surgery only | $912.01 | $1,202.26 | $2,041.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $91.20 Typical High $151.36 | Professional | 55 · Aftercare only | $69.18 | $91.20 | $151.36 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $117.49 Typical High $194.98 | Professional | 56 · Pre-op care only | $89.13 | $117.49 | $194.98 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,096.48 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $831.76 | $1,096.48 | $1,819.70 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,202.26 Typical High $1,949.84 | Professional | 54 · Surgery only | $912.01 | $1,202.26 | $1,949.84 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $93.33 Typical High $199.53 | Professional | 55 · Aftercare only | $69.18 | $93.33 | $199.53 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $120.23 Typical High $257.04 | Professional | 56 · Pre-op care only | $89.13 | $120.23 | $257.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,096.48 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $831.76 | $1,096.48 | $1,778.28 |
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· 43rd of 51
$1,549
AK $6,026TX $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.