How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,148 to $28,184Professionalmedian $1,738 · 10th to 90th $1,380 to $2,692
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 $6,606.93 Typical High $24,547.09 | Facility | None | $1,819.70 | $6,606.93 | $24,547.09 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,905.46 | Professional | None | $1,698.24 | $1,698.24 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $5,888.44 Typical High $30,902.95 | Facility | None | $1,513.56 | $5,888.44 | $30,902.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,691.53 | Professional | None | $1,479.11 | $1,737.80 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,096.48 Typical High $1,659.59 | Professional | 62 · Two surgeons | $933.25 | $1,096.48 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $275.42 Typical High $436.52 | Professional | 80 · Assistant surgeon | $234.42 | $275.42 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $239.88 Typical High $371.54 | Professional | AS · PA/NP assist | $204.17 | $239.88 | $371.54 |
CDPHP Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $25,118.86 | Facility | None | $1,047.13 | $1,862.09 | $25,118.86 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $3,630.78 | Professional | None | $1,548.82 | $1,548.82 | $3,630.78 |
Emblem Health Setting Facility Modifier None Typical Low $1,778.28 Median $2,570.40 Typical High $30,199.52 | Facility | None | $1,778.28 | $2,570.40 | $30,199.52 |
Emblem Health Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $3,548.13 | Professional | None | $1,698.24 | $1,995.26 | $3,548.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,548.82 | $2,344.23 |
MVP Health Care Setting Facility Modifier None Typical Low $1,737.80 Median $13,489.63 Typical High $31,622.78 | Facility | None | $1,737.80 | $13,489.63 | $31,622.78 |
MVP Health Care Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,778.28 | $1,778.28 | $2,951.21 |
United Setting Facility Modifier None Typical Low $575.44 Median $2,137.96 Typical High $22,908.68 | Facility | None | $575.44 | $2,137.96 | $22,908.68 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,754.23 | Professional | None | $1,258.93 | $1,698.24 | $2,754.23 |
Univera Setting Facility Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $6,606.93 | Facility | None | $1,148.15 | $1,698.24 | $6,606.93 |
Univera Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,584.89 | $2,344.23 |
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 $851.14 Median $851.14 Typical High $933.25 | Professional | 52 · Reduced service | $851.14 | $851.14 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $338.84 Typical High $380.19 | Professional | 53 · Discontinued | $338.84 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $281.84 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,318.26 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,445.44 Typical High $2,137.96 | Professional | 54 · Surgery only | $870.96 | $1,445.44 | $2,137.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $158.49 Typical High $234.42 | Professional | 55 · Aftercare only | $97.72 | $158.49 | $234.42 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $144.54 Typical High $213.80 | Professional | 56 · Pre-op care only | $87.10 | $144.54 | $213.80 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,288.25 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $794.33 | $1,288.25 | $1,905.46 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $1,258.93 Typical High $1,737.80 | Professional | 53 · Discontinued | $933.25 | $1,258.93 | $1,737.80 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,445.44 Typical High $2,137.96 | Professional | 54 · Surgery only | $870.96 | $1,445.44 | $2,137.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $158.49 Typical High $380.19 | Professional | 55 · Aftercare only | $97.72 | $158.49 | $380.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $144.54 Typical High $338.84 | Professional | 56 · Pre-op care only | $87.10 | $144.54 | $338.84 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,288.25 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $794.33 | $1,288.25 | $1,905.46 |
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· 45th of 51
$1,738
AK $6,310TX $1,175
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.