How much rates vary
Facilitymedian $3,548 · 10th to 90th $832 to $12,023Professionalmedian $309 · 10th to 90th $229 to $490
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 $1,348.96 Median $4,365.16 Typical High $10,471.29 | Facility | None | $1,348.96 | $4,365.16 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | None | $309.03 | $309.03 | $346.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $4,265.80 Typical High $42,657.95 | Facility | None | $1,288.25 | $4,265.80 | $42,657.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $501.19 | Professional | None | $269.15 | $316.23 | $501.19 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $165.96 Median $199.53 Typical High $275.42 | Professional | 62 · Two surgeons | $165.96 | $199.53 | $275.42 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $42.66 Median $48.98 Typical High $81.28 | Professional | 80 · Assistant surgeon | $42.66 | $48.98 | $81.28 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $43.65 Typical High $67.61 | Professional | AS · PA/NP assist | $37.15 | $43.65 | $67.61 |
CDPHP Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $10,964.78 | Facility | None | $3,630.78 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,949.84 Typical High $16,218.10 | Facility | None | $1,023.29 | $1,949.84 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $630.96 | Professional | None | $281.84 | $281.84 | $630.96 |
Emblem Health Setting Facility Modifier None Typical Low $331.13 Median $407.38 Typical High $30,199.52 | Facility | None | $331.13 | $407.38 | $30,199.52 |
Emblem Health Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $707.95 | Professional | None | $309.03 | $398.11 | $707.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $446.68 | Professional | None | $223.87 | $309.03 | $446.68 |
MVP Health Care Setting Facility Modifier None Typical Low $309.03 Median $4,365.16 Typical High $45,708.82 | Facility | None | $309.03 | $4,365.16 | $45,708.82 |
MVP Health Care Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $457.09 | Professional | None | $218.78 | $218.78 | $457.09 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $10,232.93 | Facility | None | $831.76 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $489.78 | Professional | None | $245.47 | $309.03 | $489.78 |
Univera Setting Facility Modifier None Typical Low $213.80 Median $309.03 Typical High $891.25 | Facility | None | $213.80 | $309.03 | $891.25 |
Univera Setting Professional Modifier None Typical Low $223.87 Median $309.03 Typical High $446.68 | Professional | None | $223.87 | $309.03 | $446.68 |
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 $218.78 Median $218.78 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $218.78 | $218.78 | $245.47 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $281.84 Typical High $407.38 | Professional | 54 · Surgery only | $162.18 | $281.84 | $407.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $31.62 Typical High $44.67 | Professional | 55 · Aftercare only | $18.20 | $31.62 | $44.67 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $31.62 Typical High $44.67 | Professional | 56 · Pre-op care only | $18.20 | $31.62 | $44.67 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $251.19 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $144.54 | $251.19 | $363.08 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $281.84 Typical High $407.38 | Professional | 54 · Surgery only | $162.18 | $281.84 | $407.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $31.62 Typical High $66.07 | Professional | 55 · Aftercare only | $18.20 | $31.62 | $66.07 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $31.62 Typical High $66.07 | Professional | 56 · Pre-op care only | $18.20 | $31.62 | $66.07 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $251.19 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $144.54 | $251.19 | $363.08 |
Where New York sits
The same service costs 5.2 times more in Alaska than in Utah. 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· 48th of 51
$309
AK $1,380UT $263
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.