How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,148 to $10,000Professionalmedian $2,089 · 10th to 90th $1,738 to $3,311
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 $2,344.23 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,344.23 | $2,454.71 | $2,454.71 |
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 $1,819.70 Median $2,137.96 Typical High $3,311.31 | Professional | None | $1,819.70 | $2,137.96 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,348.96 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,148.15 | $1,348.96 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $346.74 Typical High $524.81 | Professional | 80 · Assistant surgeon | $295.12 | $346.74 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $302.00 Typical High $457.09 | Professional | AS · PA/NP assist | $257.04 | $302.00 | $457.09 |
CDPHP Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,715.35 | Facility | None | $851.14 | $1,778.28 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $4,168.69 | Professional | None | $1,905.46 | $1,905.46 | $4,168.69 |
Emblem Health Setting Facility Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $8,317.64 | Facility | None | $2,290.87 | $2,754.23 | $8,317.64 |
Emblem Health Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $4,365.16 | Professional | None | $2,089.30 | $2,511.89 | $4,365.16 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $2,951.21 | Professional | None | $1,479.11 | $1,905.46 | $2,951.21 |
MVP Health Care Setting Facility Modifier None Typical Low $2,290.87 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,290.87 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,995.26 | $1,995.26 | $3,162.28 |
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 $1,584.89 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,584.89 | $2,137.96 | $3,388.44 |
Univera Setting Facility Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $6,309.57 | Facility | None | $1,412.54 | $2,089.30 | $6,309.57 |
Univera Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,479.11 | $1,949.84 | $2,884.03 |
10 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 54 · Surgery only Typical Low $1,737.80 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,737.80 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,737.80 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,737.80 | $1,737.80 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,778.28 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,071.52 | $1,778.28 | $2,630.27 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $194.98 Typical High $295.12 | Professional | 55 · Aftercare only | $120.23 | $194.98 | $295.12 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $177.83 Typical High $263.03 | Professional | 56 · Pre-op care only | $107.15 | $177.83 | $263.03 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,584.89 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $977.24 | $1,584.89 | $2,344.23 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,778.28 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,071.52 | $1,778.28 | $2,630.27 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $194.98 Typical High $467.74 | Professional | 55 · Aftercare only | $120.23 | $194.98 | $467.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $177.83 Typical High $426.58 | Professional | 56 · Pre-op care only | $107.15 | $177.83 | $426.58 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,584.89 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $977.24 | $1,584.89 | $2,344.23 |
Where New York sits
The same service costs 21.9 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· 44th of 51
$2,138
AK $7,586TX $347
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.