How much rates vary
Facilitymedian $3,162 · 10th to 90th $871 to $7,413Professionalmedian $537 · 10th to 90th $447 to $832
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 $1,621.81 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,621.81 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $630.96 | Professional | None | $588.84 | $630.96 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $831.76 | Professional | None | $457.09 | $537.03 | $831.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $338.84 Typical High $524.81 | Professional | 62 · Two surgeons | $288.40 | $338.84 | $524.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $72.44 Median $85.11 Typical High $131.83 | Professional | 80 · Assistant surgeon | $72.44 | $85.11 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $74.13 Typical High $114.82 | Professional | AS · PA/NP assist | $63.10 | $74.13 | $114.82 |
CDPHP Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $8,912.51 | Facility | None | $2,951.21 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $1,230.27 Typical High $2,290.87 | Facility | None | $831.76 | $1,230.27 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $1,096.48 | Professional | None | $478.63 | $478.63 | $1,096.48 |
Emblem Health Setting Facility Modifier None Typical Low $645.65 Median $831.76 Typical High $2,290.87 | Facility | None | $645.65 | $831.76 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $1,148.15 | Professional | None | $524.81 | $660.69 | $1,148.15 |
Excellus BCBS Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $758.58 | Professional | None | $380.19 | $524.81 | $758.58 |
MVP Health Care Setting Facility Modifier None Typical Low $562.34 Median $4,786.30 Typical High $5,754.40 | Facility | None | $562.34 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $891.25 | Professional | None | $812.83 | $812.83 | $891.25 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $6,309.57 | Facility | None | $851.14 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $416.87 Median $524.81 Typical High $851.14 | Professional | None | $416.87 | $524.81 | $851.14 |
Univera Setting Facility Modifier None Typical Low $363.08 Median $524.81 Typical High $2,344.23 | Facility | None | $363.08 | $524.81 | $2,344.23 |
Univera Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $758.58 | Professional | None | $380.19 | $524.81 | $758.58 |
15 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 $295.12 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $295.12 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $117.49 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $446.68 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $89.13 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $416.87 | $436.52 | $436.52 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $467.74 Typical High $691.83 | Professional | 54 · Surgery only | $275.42 | $467.74 | $691.83 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $52.48 Typical High $75.86 | Professional | 55 · Aftercare only | $30.90 | $52.48 | $75.86 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $46.77 Typical High $69.18 | Professional | 56 · Pre-op care only | $27.54 | $46.77 | $69.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $416.87 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $251.19 | $416.87 | $616.60 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $389.05 Typical High $524.81 | Professional | 53 · Discontinued | $288.40 | $389.05 | $524.81 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $467.74 Typical High $691.83 | Professional | 54 · Surgery only | $275.42 | $467.74 | $691.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $52.48 Typical High $109.65 | Professional | 55 · Aftercare only | $30.90 | $52.48 | $109.65 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $46.77 Typical High $100.00 | Professional | 56 · Pre-op care only | $27.54 | $46.77 | $100.00 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $416.87 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $251.19 | $416.87 | $616.60 |
Where New York sits
The same service costs 5.5 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· 47th of 51
$537
AK $2,188TX $398
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.