How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,023 to $10,000Professionalmedian $1,122 · 10th to 90th $851 to $2,089
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 $2,187.76 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,187.76 | $3,235.94 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,548.82 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,288.25 | Professional | None | $977.24 | $1,148.15 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $724.44 Typical High $812.83 | Professional | 62 · Two surgeons | $616.60 | $724.44 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $181.97 Typical High $204.17 | Professional | 80 · Assistant surgeon | $158.49 | $181.97 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $162.18 Typical High $181.97 | Professional | AS · PA/NP assist | $138.04 | $162.18 | $181.97 |
CDPHP Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,235.94 | Facility | None | $851.14 | $1,778.28 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $3,890.45 | Professional | None | $1,737.80 | $1,737.80 | $3,890.45 |
Emblem Health Setting Facility Modifier None Typical Low $1,230.27 Median $3,981.07 Typical High $5,623.41 | Facility | None | $1,230.27 | $3,981.07 | $5,623.41 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $1,348.96 Typical High $2,290.87 | Professional | None | $676.08 | $1,348.96 | $2,290.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,412.54 | Professional | None | $676.08 | $977.24 | $1,412.54 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
MVP Health Care Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $1,479.11 | Professional | None | $398.11 | $398.11 | $1,479.11 |
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 $741.31 Median $954.99 Typical High $1,778.28 | Professional | None | $741.31 | $954.99 | $1,778.28 |
Univera Setting Facility Modifier None Typical Low $676.08 Median $691.83 Typical High $2,041.74 | Facility | None | $676.08 | $691.83 | $2,041.74 |
Univera Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,412.54 | Professional | None | $676.08 | $977.24 | $1,412.54 |
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 $1,096.48 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,096.48 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $436.52 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,659.59 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $331.13 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $218.78 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,238.72 | $2,238.72 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $912.01 Typical High $1,288.25 | Professional | 54 · Surgery only | $524.81 | $912.01 | $1,288.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $100.00 Typical High $141.25 | Professional | 55 · Aftercare only | $58.88 | $100.00 | $141.25 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $91.20 Typical High $128.82 | Professional | 56 · Pre-op care only | $52.48 | $91.20 | $128.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $812.83 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $478.63 | $812.83 | $1,148.15 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $831.76 Typical High $1,288.25 | Professional | 54 · Surgery only | $524.81 | $831.76 | $1,288.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $100.00 Typical High $229.09 | Professional | 55 · Aftercare only | $58.88 | $100.00 | $229.09 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $91.20 Typical High $204.17 | Professional | 56 · Pre-op care only | $52.48 | $91.20 | $204.17 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $758.58 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $478.63 | $758.58 | $1,148.15 |
Where New York sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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· 50th of 51
$1,122
AK $8,511KY $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.