How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,072 to $10,000Professionalmedian $1,349 · 10th to 90th $1,096 to $2,089
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 $1,479.11 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,479.11 | $1,698.24 | $1,698.24 |
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 $1,148.15 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,348.96 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $851.14 Typical High $1,288.25 | Professional | 62 · Two surgeons | $724.44 | $851.14 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $218.78 Typical High $331.13 | Professional | 80 · Assistant surgeon | $186.21 | $218.78 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $190.55 Typical High $288.40 | Professional | AS · PA/NP assist | $162.18 | $190.55 | $288.40 |
CDPHP Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,202.26 | $2,754.23 |
Emblem Health Setting Facility Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $5,248.07 | Facility | None | $1,380.38 | $1,862.09 | $5,248.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,818.38 | Professional | None | $1,318.26 | $1,584.89 | $2,818.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,819.70 | Professional | None | $954.99 | $1,258.93 | $1,819.70 |
MVP Health Care Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,348.96 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,412.54 | $1,412.54 | $2,290.87 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,165.95 | Facility | None | $575.44 | $1,778.28 | $6,165.95 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $2,137.96 | Professional | None | $977.24 | $1,348.96 | $2,137.96 |
Univera Setting Facility Modifier None Typical Low $891.25 Median $1,318.26 Typical High $4,466.84 | Facility | None | $891.25 | $1,318.26 | $4,466.84 |
Univera Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,819.70 | Professional | None | $954.99 | $1,258.93 | $1,819.70 |
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 $741.31 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $741.31 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $295.12 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,096.48 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $218.78 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $147.91 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,174.90 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,122.02 Typical High $1,659.59 | Professional | 54 · Surgery only | $691.83 | $1,122.02 | $1,659.59 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $125.89 Typical High $186.21 | Professional | 55 · Aftercare only | $75.86 | $125.89 | $186.21 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $112.20 Typical High $165.96 | Professional | 56 · Pre-op care only | $69.18 | $112.20 | $165.96 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $1,000.00 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $616.60 | $1,000.00 | $1,513.56 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $977.24 Typical High $1,348.96 | Professional | 53 · Discontinued | $741.31 | $977.24 | $1,348.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,122.02 Typical High $1,659.59 | Professional | 54 · Surgery only | $691.83 | $1,122.02 | $1,659.59 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $125.89 Typical High $275.42 | Professional | 55 · Aftercare only | $75.86 | $125.89 | $275.42 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $112.20 Typical High $245.47 | Professional | 56 · Pre-op care only | $69.18 | $112.20 | $245.47 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $1,000.00 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $616.60 | $1,000.00 | $1,479.11 |
Where New York sits
The same service costs 5.2 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
$1,349
AK $4,898TX $933
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.