How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,072 to $10,000Professionalmedian $1,230 · 10th to 90th $977 to $1,905
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 $1,318.26 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,318.26 | $1,479.11 | $1,479.11 |
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 $1,023.29 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,230.27 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $758.58 Typical High $1,174.90 | Professional | 62 · Two surgeons | $645.65 | $758.58 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $194.98 Typical High $302.00 | Professional | 80 · Assistant surgeon | $165.96 | $194.98 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $169.82 Typical High $263.03 | Professional | AS · PA/NP assist | $144.54 | $169.82 | $263.03 |
CDPHP Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $1,096.48 Median $1,096.48 Typical High $2,454.71 | Professional | None | $1,096.48 | $1,096.48 | $2,454.71 |
Emblem Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $4,677.35 | Facility | None | $1,202.26 | $1,479.11 | $4,677.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,412.54 | $2,511.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,698.24 | Professional | None | $851.14 | $1,096.48 | $1,698.24 |
MVP Health Care Setting Facility Modifier None Typical Low $1,230.27 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,230.27 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,288.25 | $2,041.74 |
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 $891.25 Median $1,202.26 Typical High $1,905.46 | Professional | None | $891.25 | $1,202.26 | $1,905.46 |
Univera Setting Facility Modifier None Typical Low $812.83 Median $1,202.26 Typical High $4,677.35 | Facility | None | $812.83 | $1,202.26 | $4,677.35 |
Univera Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,698.24 | Professional | None | $851.14 | $1,122.02 | $1,698.24 |
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 $660.69 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $660.69 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $263.03 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,000.00 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $199.53 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $131.83 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,047.13 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $1,023.29 Typical High $1,698.24 | Professional | 54 · Surgery only | $616.60 | $1,023.29 | $1,698.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $112.20 Typical High $190.55 | Professional | 55 · Aftercare only | $67.61 | $112.20 | $190.55 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $102.33 Typical High $169.82 | Professional | 56 · Pre-op care only | $61.66 | $102.33 | $169.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $912.01 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $549.54 | $912.01 | $1,548.82 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $891.25 Typical High $1,202.26 | Professional | 53 · Discontinued | $660.69 | $891.25 | $1,202.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $1,023.29 Typical High $1,513.56 | Professional | 54 · Surgery only | $616.60 | $1,023.29 | $1,513.56 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $112.20 Typical High $269.15 | Professional | 55 · Aftercare only | $67.61 | $112.20 | $269.15 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $102.33 Typical High $239.88 | Professional | 56 · Pre-op care only | $61.66 | $102.33 | $239.88 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $912.01 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $549.54 | $912.01 | $1,380.38 |
Where New York sits
The same service costs 22.4 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· 44th of 51
$1,230
AK $4,467TX $200
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.