How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,175 to $11,482Professionalmedian $3,388 · 10th to 90th $2,754 to $5,370
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 $3,715.35 Median $4,365.16 Typical High $4,365.16 | Professional | None | $3,715.35 | $4,365.16 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,456.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $3,467.37 Typical High $5,370.32 | Professional | None | $2,951.21 | $3,467.37 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,862.09 Median $2,187.76 Typical High $3,388.44 | Professional | 62 · Two surgeons | $1,862.09 | $2,187.76 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $478.63 Median $562.34 Typical High $851.14 | Professional | 80 · Assistant surgeon | $478.63 | $562.34 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $416.87 Median $489.78 Typical High $741.31 | Professional | AS · PA/NP assist | $416.87 | $489.78 | $741.31 |
CDPHP Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $6,025.60 | Facility | None | $851.14 | $1,778.28 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $7,079.46 | Professional | None | $3,019.95 | $3,019.95 | $7,079.46 |
Emblem Health Setting Facility Modifier None Typical Low $3,019.95 Median $4,073.80 Typical High $13,182.57 | Facility | None | $3,019.95 | $4,073.80 | $13,182.57 |
Emblem Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,981.07 Typical High $7,079.46 | Professional | None | $3,388.44 | $3,981.07 | $7,079.46 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,344.23 Median $3,162.28 Typical High $4,786.30 | Professional | None | $2,344.23 | $3,162.28 | $4,786.30 |
MVP Health Care Setting Facility Modifier None Typical Low $3,388.44 Median $4,786.30 Typical High $5,754.40 | Facility | None | $3,388.44 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $5,011.87 | Professional | None | $2,951.21 | $2,951.21 | $5,011.87 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $2,454.71 Median $3,388.44 Typical High $5,495.41 | Professional | None | $2,454.71 | $3,388.44 | $5,495.41 |
Univera Setting Facility Modifier None Typical Low $2,238.72 Median $3,388.44 Typical High $10,232.93 | Facility | None | $2,238.72 | $3,388.44 | $10,232.93 |
Univera Setting Professional Modifier None Typical Low $2,344.23 Median $3,162.28 Typical High $4,786.30 | Professional | None | $2,344.23 | $3,162.28 | $4,786.30 |
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 $1,862.09 Median $2,187.76 Typical High $2,187.76 | Professional | 52 · Reduced service | $1,862.09 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $870.96 Typical High $870.96 | Professional | 53 · Discontinued | $741.31 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $3,311.31 Typical High $3,311.31 | Professional | 54 · Surgery only | $2,818.38 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $562.34 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $436.52 Typical High $436.52 | Professional | 56 · Pre-op care only | $371.54 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $3,090.30 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $2,630.27 | $3,090.30 | $3,090.30 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,818.38 Typical High $4,265.80 | Professional | 54 · Surgery only | $1,737.80 | $2,818.38 | $4,265.80 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $316.23 Typical High $478.63 | Professional | 55 · Aftercare only | $190.55 | $316.23 | $478.63 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $281.84 Typical High $426.58 | Professional | 56 · Pre-op care only | $173.78 | $281.84 | $426.58 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,570.40 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,570.40 | $3,801.89 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,862.09 Median $2,511.89 Typical High $3,467.37 | Professional | 53 · Discontinued | $1,862.09 | $2,511.89 | $3,467.37 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,818.38 Typical High $4,265.80 | Professional | 54 · Surgery only | $1,737.80 | $2,818.38 | $4,265.80 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $316.23 Typical High $691.83 | Professional | 55 · Aftercare only | $190.55 | $316.23 | $691.83 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $281.84 Typical High $616.60 | Professional | 56 · Pre-op care only | $173.78 | $281.84 | $616.60 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,570.40 Typical High $3,801.89 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,570.40 | $3,801.89 |
Where New York sits
The same service costs 21.9 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· 42nd of 51
$3,388
AK $12,303TX $562
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.