How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,072 to $9,550Professionalmedian $1,514 · 10th to 90th $1,230 to $2,344
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 $1,659.59 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,659.59 | $1,737.80 | $1,737.80 |
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 $2,344.23 | Professional | None | $1,288.25 | $1,513.56 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $954.99 Typical High $1,479.11 | Professional | 62 · Two surgeons | $812.83 | $954.99 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $245.47 Typical High $371.54 | Professional | 80 · Assistant surgeon | $208.93 | $245.47 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $213.80 Typical High $331.13 | Professional | AS · PA/NP assist | $181.97 | $213.80 | $331.13 |
CDPHP Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
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 $1,348.96 Median $1,348.96 Typical High $3,090.30 | Professional | None | $1,348.96 | $1,348.96 | $3,090.30 |
Emblem Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,819.70 Typical High $5,888.44 | Facility | None | $1,096.48 | $1,819.70 | $5,888.44 |
Emblem Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $3,162.28 | Professional | None | $1,513.56 | $1,778.28 | $3,162.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,412.54 | $2,137.96 |
MVP Health Care Setting Facility Modifier None Typical Low $1,513.56 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,513.56 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,570.40 | Professional | None | $2,041.74 | $2,041.74 | $2,570.40 |
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 $1,122.02 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,513.56 | $2,398.83 |
Univera Setting Facility Modifier None Typical Low $1,023.29 Median $1,513.56 Typical High $6,165.95 | Facility | None | $1,023.29 | $1,513.56 | $6,165.95 |
Univera Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,412.54 | $2,137.96 |
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 $831.76 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $831.76 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $331.13 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,258.93 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $251.19 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $165.96 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,202.26 | $1,202.26 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,258.93 Typical High $1,905.46 | Professional | 54 · Surgery only | $776.25 | $1,258.93 | $1,905.46 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $141.25 Typical High $213.80 | Professional | 55 · Aftercare only | $87.10 | $141.25 | $213.80 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $125.89 Typical High $190.55 | Professional | 56 · Pre-op care only | $77.62 | $125.89 | $190.55 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,148.15 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $691.83 | $1,148.15 | $1,737.80 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $1,122.02 Typical High $1,513.56 | Professional | 53 · Discontinued | $831.76 | $1,122.02 | $1,513.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $1,258.93 Typical High $1,905.46 | Professional | 54 · Surgery only | $776.25 | $1,258.93 | $1,905.46 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $141.25 Typical High $309.03 | Professional | 55 · Aftercare only | $87.10 | $141.25 | $309.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $125.89 Typical High $281.84 | Professional | 56 · Pre-op care only | $77.62 | $125.89 | $281.84 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $1,148.15 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $691.83 | $1,148.15 | $1,737.80 |
Where New York sits
The same service costs 20.9 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· 45th of 51
$1,514
AK $5,370TX $257
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.