How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,072 to $9,550Professionalmedian $1,259 · 10th to 90th $1,000 to $1,862
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 $1,698.24 Median $4,168.69 Typical High $9,332.54 | Facility | None | $1,698.24 | $4,168.69 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,348.96 | $1,621.81 | $1,621.81 |
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 $1,071.52 Median $1,258.93 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $794.33 Typical High $1,122.02 | Professional | 62 · Two surgeons | $676.08 | $794.33 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $199.53 Typical High $281.84 | Professional | 80 · Assistant surgeon | $169.82 | $199.53 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $173.78 Typical High $251.19 | Professional | AS · PA/NP assist | $147.91 | $173.78 | $251.19 |
CDPHP Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $1,000.00 Median $1,047.13 Typical High $2,570.40 | Professional | None | $1,000.00 | $1,047.13 | $2,570.40 |
Emblem Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $4,677.35 | Facility | None | $1,258.93 | $1,479.11 | $4,677.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,412.54 | $2,398.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,737.80 | Professional | None | $870.96 | $1,148.15 | $1,737.80 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,288.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,445.44 | $1,949.84 |
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 $891.25 Median $1,174.90 Typical High $1,862.09 | Professional | None | $891.25 | $1,174.90 | $1,862.09 |
Univera Setting Facility Modifier None Typical Low $831.76 Median $1,148.15 Typical High $5,011.87 | Facility | None | $831.76 | $1,148.15 | $5,011.87 |
Univera Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,737.80 | Professional | None | $870.96 | $1,148.15 | $1,737.80 |
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 $676.08 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $676.08 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $269.15 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,000.00 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $204.17 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $134.90 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $933.25 | $1,148.15 | $1,148.15 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $1,023.29 Typical High $1,698.24 | Professional | 54 · Surgery only | $630.96 | $1,023.29 | $1,698.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $114.82 Typical High $190.55 | Professional | 55 · Aftercare only | $70.79 | $114.82 | $190.55 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $102.33 Typical High $169.82 | Professional | 56 · Pre-op care only | $63.10 | $102.33 | $169.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $933.25 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $575.44 | $933.25 | $1,548.82 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $870.96 Typical High $1,258.93 | Professional | 53 · Discontinued | $676.08 | $870.96 | $1,258.93 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $1,023.29 Typical High $1,584.89 | Professional | 54 · Surgery only | $630.96 | $1,023.29 | $1,584.89 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $114.82 Typical High $251.19 | Professional | 55 · Aftercare only | $70.79 | $114.82 | $251.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $102.33 Typical High $229.09 | Professional | 56 · Pre-op care only | $63.10 | $102.33 | $229.09 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $933.25 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $575.44 | $933.25 | $1,412.54 |
Where New York sits
The same service costs 5.4 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
$1,259
AK $4,571TX $851
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.