How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,072 to $9,772Professionalmedian $1,585 · 10th to 90th $1,259 to $2,455
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 $1,737.80 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,737.80 | $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 $1,348.96 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,584.89 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,000.00 Typical High $1,513.56 | Professional | 62 · Two surgeons | $851.14 | $1,000.00 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $251.19 Typical High $389.05 | Professional | 80 · Assistant surgeon | $213.80 | $251.19 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $223.87 Typical High $338.84 | Professional | AS · PA/NP assist | $186.21 | $223.87 | $338.84 |
CDPHP Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
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 $1,412.54 Median $1,412.54 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,412.54 | $3,162.28 |
Emblem Health Setting Facility Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $6,165.95 | Facility | None | $1,513.56 | $1,905.46 | $6,165.95 |
Emblem Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $3,311.31 | Professional | None | $1,548.82 | $1,862.09 | $3,311.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,479.11 | $2,187.76 |
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 $1,584.89 Median $1,584.89 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,584.89 | $2,691.53 |
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 $1,148.15 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,548.82 | $2,511.89 |
Univera Setting Facility Modifier None Typical Low $1,047.13 Median $1,548.82 Typical High $5,754.40 | Facility | None | $1,047.13 | $1,548.82 | $5,754.40 |
Univera Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,479.11 | $2,187.76 |
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 $870.96 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $870.96 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $346.74 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,288.25 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $257.04 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $173.78 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,380.38 | $1,380.38 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,318.26 Typical High $2,187.76 | Professional | 54 · Surgery only | $794.33 | $1,318.26 | $2,187.76 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $147.91 Typical High $239.88 | Professional | 55 · Aftercare only | $89.13 | $147.91 | $239.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $131.83 Typical High $218.78 | Professional | 56 · Pre-op care only | $79.43 | $131.83 | $218.78 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,202.26 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $724.44 | $1,202.26 | $1,949.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $1,148.15 Typical High $1,584.89 | Professional | 53 · Discontinued | $870.96 | $1,148.15 | $1,584.89 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,318.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $794.33 | $1,318.26 | $1,995.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $147.91 Typical High $323.59 | Professional | 55 · Aftercare only | $89.13 | $147.91 | $323.59 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $131.83 Typical High $288.40 | Professional | 56 · Pre-op care only | $79.43 | $131.83 | $288.40 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $1,202.26 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $724.44 | $1,202.26 | $1,778.28 |
Where New York sits
The same service costs 20.4 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· 44th of 51
$1,585
AK $5,495TX $269
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.