How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,445 to $19,055Professionalmedian $1,202 · 10th to 90th $891 to $1,862
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 $6,025.60 Typical High $12,882.50 | Facility | None | $1,819.70 | $6,025.60 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,348.96 | $1,380.38 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $6,918.31 Typical High $13,489.63 | Facility | None | $1,819.70 | $6,918.31 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,047.13 | $1,230.27 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $776.25 Typical High $1,174.90 | Professional | 62 · Two surgeons | $660.69 | $776.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $194.98 Typical High $302.00 | Professional | 80 · Assistant surgeon | $165.96 | $194.98 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $169.82 Typical High $263.03 | Professional | AS · PA/NP assist | $144.54 | $169.82 | $263.03 |
CDPHP Setting Facility Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $19,952.62 | Facility | None | $6,606.93 | $6,606.93 | $19,952.62 |
CDPHP Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $25,118.86 Typical High $38,018.94 | Facility | None | $1,318.26 | $25,118.86 | $38,018.94 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,096.48 | $2,454.71 |
Emblem Health Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $50,118.72 | Facility | None | $1,348.96 | $4,786.30 | $50,118.72 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,202.26 | $1,445.44 | $2,570.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,698.24 | Professional | None | $851.14 | $1,122.02 | $1,698.24 |
MVP Health Care Setting Facility Modifier None Typical Low $1,230.27 Median $16,595.87 Typical High $45,708.82 | Facility | None | $1,230.27 | $16,595.87 | $45,708.82 |
MVP Health Care Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,778.28 | Professional | None | $891.25 | $891.25 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,630.78 Typical High $22,908.68 | Facility | None | $1,230.27 | $3,630.78 | $22,908.68 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,949.84 | Professional | None | $912.01 | $1,202.26 | $1,949.84 |
Univera Setting Facility Modifier None Typical Low $812.83 Median $1,202.26 Typical High $3,715.35 | Facility | None | $812.83 | $1,202.26 | $3,715.35 |
Univera Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,698.24 | Professional | None | $851.14 | $1,122.02 | $1,698.24 |
9 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 78 · Unplanned return to OR Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $933.25 | $977.24 | $977.24 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,047.13 Typical High $1,584.89 | Professional | 54 · Surgery only | $645.65 | $1,047.13 | $1,584.89 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $79.43 Typical High $120.23 | Professional | 55 · Aftercare only | $47.86 | $79.43 | $120.23 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $102.33 Typical High $154.88 | Professional | 56 · Pre-op care only | $61.66 | $102.33 | $154.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $954.99 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $575.44 | $954.99 | $1,445.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $1,047.13 Typical High $1,584.89 | Professional | 54 · Surgery only | $645.65 | $1,047.13 | $1,584.89 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $79.43 Typical High $173.78 | Professional | 55 · Aftercare only | $47.86 | $79.43 | $173.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $102.33 Typical High $223.87 | Professional | 56 · Pre-op care only | $61.66 | $102.33 | $223.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $954.99 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $575.44 | $954.99 | $1,445.44 |
Where New York sits
The same service costs 24.0 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
$1,230
AK $5,129TX $214
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.