How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,047 to $12,023Professionalmedian $1,072 · 10th to 90th $871 to $1,660
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 $1,148.15 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,348.96 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,778.28 | $6,760.83 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,659.59 | Professional | None | $912.01 | $1,071.52 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $173.78 Typical High $269.15 | Professional | 80 · Assistant surgeon | $147.91 | $173.78 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $234.42 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $234.42 |
CDPHP Setting Facility Modifier None Typical Low $3,019.95 Median $4,365.16 Typical High $12,882.50 | Facility | None | $3,019.95 | $4,365.16 | $12,882.50 |
CDPHP Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $933.25 Median $954.99 Typical High $2,344.23 | Professional | None | $933.25 | $954.99 | $2,344.23 |
Emblem Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $4,168.69 | Facility | None | $1,148.15 | $1,412.54 | $4,168.69 |
Emblem Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,258.93 | $2,238.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,445.44 | Professional | None | $741.31 | $954.99 | $1,445.44 |
MVP Health Care Setting Facility Modifier None Typical Low $1,023.29 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,023.29 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,318.26 | $1,584.89 |
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 $794.33 Median $1,071.52 Typical High $1,698.24 | Professional | None | $794.33 | $1,071.52 | $1,698.24 |
Univera Setting Facility Modifier None Typical Low $707.95 Median $1,047.13 Typical High $2,951.21 | Facility | None | $707.95 | $1,047.13 | $2,951.21 |
Univera Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,445.44 | Professional | None | $741.31 | $1,000.00 | $1,445.44 |
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 54 · Surgery only Typical Low $870.96 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $870.96 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $812.83 | $954.99 | $954.99 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $891.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $537.03 | $891.25 | $1,318.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $100.00 Typical High $144.54 | Professional | 55 · Aftercare only | $60.26 | $100.00 | $144.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $89.13 Typical High $131.83 | Professional | 56 · Pre-op care only | $53.70 | $89.13 | $131.83 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $812.83 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $478.63 | $812.83 | $1,174.90 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $630.96 Median $1,288.25 Typical High $1,445.44 | Facility | 54 · Surgery only | $630.96 | $1,288.25 | $1,445.44 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $70.79 Median $144.54 Typical High $177.83 | Facility | 55 · Aftercare only | $70.79 | $144.54 | $177.83 |
Univera Setting Facility Modifier 56 · Pre-op care only Typical Low $63.10 Median $128.82 Typical High $158.49 | Facility | 56 · Pre-op care only | $63.10 | $128.82 | $158.49 |
Univera Setting Facility Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $1,148.15 Typical High $1,445.44 | Facility | 78 · Unplanned return to OR | $562.34 | $1,148.15 | $1,445.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $891.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $537.03 | $891.25 | $1,318.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $100.00 Typical High $234.42 | Professional | 55 · Aftercare only | $60.26 | $100.00 | $234.42 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $89.13 Typical High $208.93 | Professional | 56 · Pre-op care only | $53.70 | $89.13 | $208.93 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $812.83 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $478.63 | $812.83 | $1,174.90 |
Where New York sits
The same service costs 5.4 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
$1,072
AK $3,981TX $741
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.