How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,148 to $10,000Professionalmedian $2,344 · 10th to 90th $1,905 to $3,631
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 $2,570.40 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,570.40 | $2,951.21 | $2,951.21 |
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 $1,995.26 Median $2,344.23 Typical High $3,630.78 | Professional | None | $1,995.26 | $2,344.23 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,479.11 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,258.93 | $1,479.11 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $380.19 Typical High $575.44 | Professional | 80 · Assistant surgeon | $323.59 | $380.19 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $331.13 Typical High $512.86 | Professional | AS · PA/NP assist | $281.84 | $331.13 | $512.86 |
CDPHP Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,467.37 | $3,467.37 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $4,073.80 | Facility | None | $851.14 | $1,778.28 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $4,786.30 | Professional | None | $2,089.30 | $2,089.30 | $4,786.30 |
Emblem Health Setting Facility Modifier None Typical Low $2,454.71 Median $3,548.13 Typical High $9,120.11 | Facility | None | $2,454.71 | $3,548.13 | $9,120.11 |
Emblem Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,754.23 Typical High $4,786.30 | Professional | None | $2,344.23 | $2,754.23 | $4,786.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $3,311.31 | Professional | None | $1,659.59 | $2,137.96 | $3,311.31 |
MVP Health Care Setting Facility Modifier None Typical Low $2,344.23 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,344.23 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $3,890.45 | Professional | None | $1,949.84 | $1,949.84 | $3,890.45 |
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 $1,659.59 Median $2,344.23 Typical High $3,715.35 | Professional | None | $1,659.59 | $2,344.23 | $3,715.35 |
Univera Setting Facility Modifier None Typical Low $1,548.82 Median $2,344.23 Typical High $7,079.46 | Facility | None | $1,548.82 | $2,344.23 | $7,079.46 |
Univera Setting Professional Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $3,311.31 | Professional | None | $1,659.59 | $2,137.96 | $3,311.31 |
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 $1,288.25 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,288.25 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $512.86 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,905.46 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $389.05 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $257.04 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,041.74 | $2,041.74 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,949.84 Typical High $2,951.21 | Professional | 54 · Surgery only | $1,202.26 | $1,949.84 | $2,951.21 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $213.80 Typical High $331.13 | Professional | 55 · Aftercare only | $131.83 | $213.80 | $331.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $194.98 Typical High $295.12 | Professional | 56 · Pre-op care only | $120.23 | $194.98 | $295.12 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,737.80 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,737.80 | $2,630.27 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,288.25 Median $1,737.80 Typical High $2,344.23 | Professional | 53 · Discontinued | $1,288.25 | $1,737.80 | $2,344.23 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,949.84 Typical High $2,951.21 | Professional | 54 · Surgery only | $1,202.26 | $1,949.84 | $2,951.21 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $213.80 Typical High $478.63 | Professional | 55 · Aftercare only | $131.83 | $213.80 | $478.63 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $194.98 Typical High $426.58 | Professional | 56 · Pre-op care only | $120.23 | $194.98 | $426.58 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,737.80 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,737.80 | $2,630.27 |
Where New York sits
The same service costs 21.4 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
$2,344
AK $8,318TX $389
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.