How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,047 to $9,772Professionalmedian $1,445 · 10th to 90th $1,175 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 $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 $1,584.89 Median $1,584.89 Typical High $1,621.81 | Professional | None | $1,584.89 | $1,584.89 | $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 $1,258.93 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,479.11 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $933.25 Typical High $1,412.54 | Professional | 62 · Two surgeons | $776.25 | $933.25 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $234.42 Typical High $338.84 | Professional | 80 · Assistant surgeon | $199.53 | $234.42 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $204.17 Typical High $316.23 | Professional | AS · PA/NP assist | $173.78 | $204.17 | $316.23 |
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 $1,318.26 Median $1,318.26 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,318.26 | $2,884.03 |
Emblem Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $5,754.40 | Facility | None | $1,047.13 | $1,778.28 | $5,754.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $3,090.30 | Professional | None | $1,445.44 | $1,737.80 | $3,090.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,318.26 | $1,995.26 |
MVP Health Care Setting Facility Modifier None Typical Low $1,412.54 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,412.54 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,348.96 | $2,454.71 |
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 $1,071.52 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,071.52 | $1,445.44 | $2,344.23 |
Univera Setting Facility Modifier None Typical Low $977.24 Median $1,445.44 Typical High $5,128.61 | Facility | None | $977.24 | $1,445.44 | $5,128.61 |
Univera Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,380.38 | $1,995.26 |
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 $794.33 Typical High $812.83 | Professional | 52 · Reduced service | $794.33 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $323.59 | Professional | 53 · Discontinued | $316.23 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $162.18 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $1,122.02 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,230.27 Typical High $1,819.70 | Professional | 54 · Surgery only | $741.31 | $1,230.27 | $1,819.70 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $138.04 Typical High $199.53 | Professional | 55 · Aftercare only | $83.18 | $138.04 | $199.53 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $123.03 Typical High $181.97 | Professional | 56 · Pre-op care only | $74.13 | $123.03 | $181.97 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,122.02 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $676.08 | $1,122.02 | $1,621.81 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $1,071.52 Typical High $1,445.44 | Professional | 53 · Discontinued | $794.33 | $1,071.52 | $1,445.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,230.27 Typical High $1,819.70 | Professional | 54 · Surgery only | $741.31 | $1,230.27 | $1,819.70 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $138.04 Typical High $323.59 | Professional | 55 · Aftercare only | $83.18 | $138.04 | $323.59 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $123.03 Typical High $288.40 | Professional | 56 · Pre-op care only | $74.13 | $123.03 | $288.40 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,122.02 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $676.08 | $1,122.02 | $1,621.81 |
Where New York sits
The same service costs 5.1 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
$1,445
AK $5,129TX $1,000
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.