How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,047 to $9,772Professionalmedian $1,047 · 10th to 90th $776 to $1,585
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,174.90 | $1,230.27 | $1,230.27 |
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 $891.25 Median $1,071.52 Typical High $1,621.81 | Professional | None | $891.25 | $1,071.52 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $1,000.00 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $169.82 Typical High $257.04 | Professional | 80 · Assistant surgeon | $144.54 | $169.82 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $147.91 Typical High $223.87 | Professional | AS · PA/NP assist | $125.89 | $147.91 | $223.87 |
CDPHP Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $954.99 Median $954.99 Typical High $2,089.30 | Professional | None | $954.99 | $954.99 | $2,089.30 |
Emblem Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $4,168.69 | Facility | None | $1,047.13 | $1,318.26 | $4,168.69 |
Emblem Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,288.25 | $2,238.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,479.11 | Professional | None | $741.31 | $1,000.00 | $1,479.11 |
MVP Health Care Setting Facility Modifier None Typical Low $1,023.29 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,023.29 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,548.82 | Professional | None | $758.58 | $758.58 | $1,548.82 |
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 $776.25 Median $1,047.13 Typical High $1,659.59 | Professional | None | $776.25 | $1,047.13 | $1,659.59 |
Univera Setting Facility Modifier None Typical Low $707.95 Median $1,047.13 Typical High $3,090.30 | Facility | None | $707.95 | $1,047.13 | $3,090.30 |
Univera Setting Professional Modifier None Typical Low $741.31 Median $1,000.00 Typical High $1,479.11 | Professional | None | $741.31 | $1,000.00 | $1,479.11 |
9 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 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $851.14 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $912.01 Typical High $1,348.96 | Professional | 54 · Surgery only | $537.03 | $912.01 | $1,348.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $100.00 Typical High $147.91 | Professional | 55 · Aftercare only | $60.26 | $100.00 | $147.91 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $91.20 Typical High $134.90 | Professional | 56 · Pre-op care only | $53.70 | $91.20 | $134.90 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $812.83 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $489.78 | $812.83 | $1,202.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $912.01 Typical High $1,348.96 | Professional | 54 · Surgery only | $537.03 | $912.01 | $1,348.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $100.00 Typical High $213.80 | Professional | 55 · Aftercare only | $60.26 | $100.00 | $213.80 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $91.20 Typical High $194.98 | Professional | 56 · Pre-op care only | $53.70 | $91.20 | $194.98 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $812.83 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $489.78 | $812.83 | $1,202.26 |
Where New York sits
The same service costs 5.8 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· 46th of 51
$1,047
AK $4,467TX $776
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.