How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,349 to $12,882Professionalmedian $708 · 10th to 90th $562 to $1,148
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 $1,905.46 Median $6,456.54 Typical High $13,489.63 | Facility | None | $1,905.46 | $6,456.54 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $912.01 | Professional | None | $794.33 | $912.01 | $912.01 |
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 $562.34 Median $660.69 Typical High $1,148.15 | Professional | None | $562.34 | $660.69 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $416.87 Typical High $707.95 | Professional | 62 · Two surgeons | $354.81 | $416.87 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $107.15 Typical High $181.97 | Professional | 80 · Assistant surgeon | $91.20 | $107.15 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $93.33 Typical High $158.49 | Professional | AS · PA/NP assist | $79.43 | $93.33 | $158.49 |
CDPHP Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $12,302.69 | Facility | None | $4,073.80 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $5,128.61 Typical High $10,232.93 | Facility | None | $1,479.11 | $5,128.61 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $1,479.11 | Professional | None | $645.65 | $660.69 | $1,479.11 |
Emblem Health Setting Facility Modifier None Typical Low $794.33 Median $1,230.27 Typical High $3,019.95 | Facility | None | $794.33 | $1,230.27 | $3,019.95 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,548.82 | Professional | None | $724.44 | $870.96 | $1,548.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $1,023.29 | Professional | None | $512.86 | $691.83 | $1,023.29 |
MVP Health Care Setting Facility Modifier None Typical Low $758.58 Median $6,456.54 Typical High $7,079.46 | Facility | None | $758.58 | $6,456.54 | $7,079.46 |
MVP Health Care Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,230.27 | Professional | None | $977.24 | $977.24 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $13,182.57 | Facility | None | $1,318.26 | $4,168.69 | $13,182.57 |
United Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,174.90 | Professional | None | $549.54 | $724.44 | $1,174.90 |
Univera Setting Facility Modifier None Typical Low $489.78 Median $724.44 Typical High $2,884.03 | Facility | None | $489.78 | $724.44 | $2,884.03 |
Univera Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $1,023.29 | Professional | None | $512.86 | $691.83 | $1,023.29 |
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 $398.11 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $398.11 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $158.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $602.56 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $120.23 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $79.43 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $562.34 | $630.96 | $630.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $602.56 Typical High $891.25 | Professional | 54 · Surgery only | $363.08 | $602.56 | $891.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $89.13 Typical High $134.90 | Professional | 55 · Aftercare only | $53.70 | $89.13 | $134.90 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $75.86 Typical High $112.20 | Professional | 56 · Pre-op care only | $45.71 | $75.86 | $112.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $524.81 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $316.23 | $524.81 | $776.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $537.03 Typical High $724.44 | Professional | 53 · Discontinued | $398.11 | $537.03 | $724.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $602.56 Typical High $891.25 | Professional | 54 · Surgery only | $363.08 | $602.56 | $891.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $89.13 Typical High $194.98 | Professional | 55 · Aftercare only | $53.70 | $89.13 | $194.98 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $75.86 Typical High $165.96 | Professional | 56 · Pre-op care only | $45.71 | $75.86 | $165.96 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $524.81 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $316.23 | $524.81 | $776.25 |
Where New York sits
The same service costs 25.1 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· 45th of 51
$708
AK $3,090TX $123
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.