How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,072 to $9,550Professionalmedian $1,514 · 10th to 90th $1,202 to $2,239
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 $4,168.69 Typical High $9,332.54 | Facility | None | $1,819.70 | $4,168.69 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,949.84 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,715.19 | Facility | None | $1,548.82 | $4,466.84 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,513.56 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $954.99 Typical High $1,318.26 | Professional | 62 · Two surgeons | $794.33 | $954.99 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $239.88 Typical High $338.84 | Professional | 80 · Assistant surgeon | $204.17 | $239.88 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $208.93 Typical High $295.12 | Professional | AS · PA/NP assist | $177.83 | $208.93 | $295.12 |
CDPHP Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
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 $1,230.27 Typical High $3,019.95 | Professional | None | $1,202.26 | $1,230.27 | $3,019.95 |
Emblem Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,737.80 Typical High $5,370.32 | Facility | None | $1,096.48 | $1,737.80 | $5,370.32 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,659.59 | $2,818.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,290.87 | Professional | None | $1,047.13 | $1,348.96 | $2,290.87 |
MVP Health Care Setting Facility Modifier None Typical Low $1,584.89 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,584.89 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,698.24 | $1,698.24 | $2,344.23 |
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 $1,047.13 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,412.54 | $2,238.72 |
Univera Setting Facility Modifier None Typical Low $977.24 Median $1,380.38 Typical High $5,248.07 | Facility | None | $977.24 | $1,380.38 | $5,248.07 |
Univera Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,348.96 | $2,089.30 |
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 $794.33 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $794.33 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $323.59 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,202.26 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $239.88 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $162.18 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,380.38 | $1,380.38 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,202.26 Typical High $2,089.30 | Professional | 54 · Surgery only | $758.58 | $1,202.26 | $2,089.30 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $134.90 Typical High $234.42 | Professional | 55 · Aftercare only | $83.18 | $134.90 | $234.42 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $120.23 Typical High $208.93 | Professional | 56 · Pre-op care only | $75.86 | $120.23 | $208.93 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,096.48 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $676.08 | $1,096.48 | $1,862.09 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $1,047.13 Typical High $1,479.11 | Professional | 53 · Discontinued | $812.83 | $1,047.13 | $1,479.11 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,202.26 Typical High $1,949.84 | Professional | 54 · Surgery only | $758.58 | $1,202.26 | $1,949.84 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $134.90 Typical High $323.59 | Professional | 55 · Aftercare only | $83.18 | $134.90 | $323.59 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $120.23 Typical High $295.12 | Professional | 56 · Pre-op care only | $75.86 | $120.23 | $295.12 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,096.48 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $676.08 | $1,096.48 | $1,737.80 |
Where New York sits
The same service costs 22.9 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· 42nd of 51
$1,514
AK $5,495TX $240
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.