How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,148 to $10,471Professionalmedian $3,981 · 10th to 90th $3,236 to $6,166
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 $4,365.16 Median $4,570.88 Typical High $4,570.88 | Professional | None | $4,365.16 | $4,570.88 | $4,570.88 |
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 $3,388.44 Median $4,073.80 Typical High $6,025.60 | Professional | None | $3,388.44 | $4,073.80 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,137.96 Median $2,511.89 Typical High $3,801.89 | Professional | 62 · Two surgeons | $2,137.96 | $2,511.89 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $549.54 Median $645.65 Typical High $954.99 | Professional | 80 · Assistant surgeon | $549.54 | $645.65 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $478.63 Median $562.34 Typical High $851.14 | Professional | AS · PA/NP assist | $478.63 | $562.34 | $851.14 |
CDPHP Setting Professional Modifier None Typical Low $5,888.44 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,888.44 | $5,888.44 | $5,888.44 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $6,918.31 | Facility | None | $851.14 | $1,778.28 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $7,943.28 | Professional | None | $3,630.78 | $3,630.78 | $7,943.28 |
Emblem Health Setting Facility Modifier None Typical Low $3,548.13 Median $4,786.30 Typical High $15,488.17 | Facility | None | $3,548.13 | $4,786.30 | $15,488.17 |
Emblem Health Setting Professional Modifier None Typical Low $3,981.07 Median $4,677.35 Typical High $8,317.64 | Professional | None | $3,981.07 | $4,677.35 | $8,317.64 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,818.38 Median $3,630.78 Typical High $5,495.41 | Professional | None | $2,818.38 | $3,630.78 | $5,495.41 |
MVP Health Care Setting Facility Modifier None Typical Low $3,715.35 Median $4,786.30 Typical High $5,754.40 | Facility | None | $3,715.35 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $6,606.93 | Professional | None | $3,311.31 | $3,311.31 | $6,606.93 |
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 $2,884.03 Median $3,981.07 Typical High $6,456.54 | Professional | None | $2,884.03 | $3,981.07 | $6,456.54 |
Univera Setting Facility Modifier None Typical Low $2,691.53 Median $3,981.07 Typical High $12,882.50 | Facility | None | $2,691.53 | $3,981.07 | $12,882.50 |
Univera Setting Professional Modifier None Typical Low $2,818.38 Median $3,715.35 Typical High $5,495.41 | Professional | None | $2,818.38 | $3,715.35 | $5,495.41 |
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 $2,187.76 Median $2,290.87 Typical High $2,290.87 | Professional | 52 · Reduced service | $2,187.76 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $870.96 Median $912.01 Typical High $912.01 | Professional | 53 · Discontinued | $870.96 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,311.31 Median $3,388.44 Typical High $3,388.44 | Professional | 54 · Surgery only | $3,311.31 | $3,388.44 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 55 · Aftercare only | $660.69 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 56 · Pre-op care only | $436.52 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,090.30 Median $3,162.28 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $3,090.30 | $3,162.28 | $3,162.28 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $3,311.31 Typical High $5,011.87 | Professional | 54 · Surgery only | $2,041.74 | $3,311.31 | $5,011.87 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $371.54 Typical High $549.54 | Professional | 55 · Aftercare only | $229.09 | $371.54 | $549.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $331.13 Typical High $501.19 | Professional | 56 · Pre-op care only | $204.17 | $331.13 | $501.19 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $3,019.95 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $1,819.70 | $3,019.95 | $4,466.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $2,187.76 Median $2,951.21 Typical High $3,890.45 | Professional | 53 · Discontinued | $2,187.76 | $2,951.21 | $3,890.45 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $3,311.31 Typical High $5,011.87 | Professional | 54 · Surgery only | $2,041.74 | $3,311.31 | $5,011.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $371.54 Typical High $891.25 | Professional | 55 · Aftercare only | $229.09 | $371.54 | $891.25 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $331.13 Typical High $794.33 | Professional | 56 · Pre-op care only | $204.17 | $331.13 | $794.33 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $3,019.95 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $1,819.70 | $3,019.95 | $4,466.84 |
Where New York sits
The same service costs 21.9 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· 41st of 51
$3,981
AK $14,125TX $646
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.