How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,122 to $10,233Professionalmedian $1,413 · 10th to 90th $1,096 to $2,138
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 $1,905.46 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,905.46 | $6,309.57 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,548.82 | Professional | None | $1,513.56 | $1,513.56 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,548.82 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,412.54 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $891.25 Typical High $1,348.96 | Professional | 62 · Two surgeons | $758.58 | $891.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $229.09 Typical High $316.23 | Professional | 80 · Assistant surgeon | $194.98 | $229.09 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $199.53 Typical High $302.00 | Professional | AS · PA/NP assist | $169.82 | $199.53 | $302.00 |
CDPHP Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $7,762.47 | Facility | None | $851.14 | $1,778.28 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,754.23 | Professional | None | $1,258.93 | $1,258.93 | $2,754.23 |
Emblem Health Setting Facility Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $5,495.41 | Facility | None | $1,412.54 | $1,698.24 | $5,495.41 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,951.21 | Professional | None | $1,380.38 | $1,659.59 | $2,951.21 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,288.25 | $1,995.26 |
MVP Health Care Setting Facility Modifier None Typical Low $1,445.44 Median $5,754.40 Typical High $8,912.51 | Facility | None | $1,445.44 | $5,754.40 | $8,912.51 |
MVP Health Care Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,344.23 | Professional | None | $1,096.48 | $1,096.48 | $2,344.23 |
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 $1,047.13 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,047.13 | $1,412.54 | $2,238.72 |
Univera Setting Facility Modifier None Typical Low $933.25 Median $1,380.38 Typical High $5,011.87 | Facility | None | $933.25 | $1,380.38 | $5,011.87 |
Univera Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,288.25 | $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 $758.58 Median $758.58 Typical High $776.25 | Professional | 52 · Reduced service | $758.58 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $309.03 | Professional | 53 · Discontinued | $302.00 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $229.09 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $154.88 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,071.52 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,174.90 Typical High $1,778.28 | Professional | 54 · Surgery only | $724.44 | $1,174.90 | $1,778.28 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $128.82 Typical High $199.53 | Professional | 55 · Aftercare only | $79.43 | $128.82 | $199.53 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $117.49 Typical High $177.83 | Professional | 56 · Pre-op care only | $72.44 | $117.49 | $177.83 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,047.13 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $645.65 | $1,047.13 | $1,584.89 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $1,023.29 Typical High $1,412.54 | Professional | 53 · Discontinued | $776.25 | $1,023.29 | $1,412.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,174.90 Typical High $1,778.28 | Professional | 54 · Surgery only | $724.44 | $1,174.90 | $1,778.28 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $128.82 Typical High $288.40 | Professional | 55 · Aftercare only | $79.43 | $128.82 | $288.40 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $117.49 Typical High $257.04 | Professional | 56 · Pre-op care only | $72.44 | $117.49 | $257.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,047.13 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $645.65 | $1,047.13 | $1,584.89 |
Where New York sits
The same service costs 5.2 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
$1,413
AK $5,129TX $977
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.