How much rates vary
Facilitymedian $3,890 · 10th to 90th $813 to $9,772Professionalmedian $631 · 10th to 90th $513 to $955
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 $1,621.81 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,621.81 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $707.95 | Professional | None | $691.83 | $691.83 | $707.95 |
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 $524.81 Median $616.60 Typical High $1,000.00 | Professional | None | $524.81 | $616.60 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $389.05 Typical High $575.44 | Professional | 62 · Two surgeons | $331.13 | $389.05 | $575.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $85.11 Median $100.00 Typical High $147.91 | Professional | 80 · Assistant surgeon | $85.11 | $100.00 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $87.10 Typical High $134.90 | Professional | AS · PA/NP assist | $74.13 | $87.10 | $134.90 |
CDPHP Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
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 $562.34 Median $562.34 Typical High $1,230.27 | Professional | None | $562.34 | $562.34 | $1,230.27 |
Emblem Health Setting Facility Modifier None Typical Low $467.74 Median $812.83 Typical High $2,630.27 | Facility | None | $467.74 | $812.83 | $2,630.27 |
Emblem Health Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $1,380.38 | Professional | None | $630.96 | $794.33 | $1,380.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $912.01 | Professional | None | $446.68 | $630.96 | $912.01 |
MVP Health Care Setting Facility Modifier None Typical Low $616.60 Median $4,786.30 Typical High $5,754.40 | Facility | None | $616.60 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,071.52 | Professional | None | $724.44 | $724.44 | $1,071.52 |
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 $478.63 Median $616.60 Typical High $1,000.00 | Professional | None | $478.63 | $616.60 | $1,000.00 |
Univera Setting Facility Modifier None Typical Low $426.58 Median $630.96 Typical High $2,187.76 | Facility | None | $426.58 | $630.96 | $2,187.76 |
Univera Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $912.01 | Professional | None | $446.68 | $630.96 | $912.01 |
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 $338.84 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 53 · Discontinued | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $524.81 | Professional | 54 · Surgery only | $512.86 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $104.71 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $70.79 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $489.78 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $562.34 Typical High $812.83 | Professional | 54 · Surgery only | $331.13 | $562.34 | $812.83 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $63.10 Typical High $91.20 | Professional | 55 · Aftercare only | $36.31 | $63.10 | $91.20 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $56.23 Typical High $81.28 | Professional | 56 · Pre-op care only | $33.11 | $56.23 | $81.28 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $512.86 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $295.12 | $512.86 | $724.44 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $457.09 Typical High $616.60 | Professional | 53 · Discontinued | $346.74 | $457.09 | $616.60 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $562.34 Typical High $812.83 | Professional | 54 · Surgery only | $331.13 | $562.34 | $812.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $63.10 Typical High $131.83 | Professional | 55 · Aftercare only | $36.31 | $63.10 | $131.83 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $56.23 Typical High $117.49 | Professional | 56 · Pre-op care only | $33.11 | $56.23 | $117.49 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $512.86 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $295.12 | $512.86 | $724.44 |
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
$631
AK $2,512TX $468
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.