How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,000 to $10,233Professionalmedian $1,000 · 10th to 90th $813 to $1,549
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,122.02 | $1,230.27 | $1,230.27 |
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 $851.14 Median $1,000.00 Typical High $1,584.89 | Professional | None | $851.14 | $1,000.00 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $630.96 Typical High $977.24 | Professional | 62 · Two surgeons | $537.03 | $630.96 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $162.18 Typical High $245.47 | Professional | 80 · Assistant surgeon | $138.04 | $162.18 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $141.25 Typical High $208.93 | Professional | AS · PA/NP assist | $120.23 | $141.25 | $208.93 |
CDPHP Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $912.01 Median $912.01 Typical High $2,041.74 | Professional | None | $912.01 | $912.01 | $2,041.74 |
Emblem Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $3,981.07 | Facility | None | $1,096.48 | $1,230.27 | $3,981.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,202.26 | $2,137.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,412.54 | Professional | None | $707.95 | $954.99 | $1,412.54 |
MVP Health Care Setting Facility Modifier None Typical Low $1,023.29 Median $5,754.40 Typical High $41,686.94 | Facility | None | $1,023.29 | $5,754.40 | $41,686.94 |
MVP Health Care Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,318.26 | $1,698.24 |
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 $758.58 Median $1,000.00 Typical High $1,584.89 | Professional | None | $758.58 | $1,000.00 | $1,584.89 |
Univera Setting Facility Modifier None Typical Low $676.08 Median $1,000.00 Typical High $3,467.37 | Facility | None | $676.08 | $1,000.00 | $3,467.37 |
Univera Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,412.54 | Professional | None | $707.95 | $954.99 | $1,412.54 |
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 $549.54 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $223.87 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $112.20 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $870.96 | $870.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $851.14 Typical High $1,288.25 | Professional | 54 · Surgery only | $512.86 | $851.14 | $1,288.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $95.50 Typical High $141.25 | Professional | 55 · Aftercare only | $57.54 | $95.50 | $141.25 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $85.11 Typical High $128.82 | Professional | 56 · Pre-op care only | $51.29 | $85.11 | $128.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $776.25 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $467.74 | $776.25 | $1,148.15 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $741.31 Typical High $1,000.00 | Professional | 53 · Discontinued | $549.54 | $741.31 | $1,000.00 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $851.14 Typical High $1,288.25 | Professional | 54 · Surgery only | $512.86 | $851.14 | $1,288.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $95.50 Typical High $204.17 | Professional | 55 · Aftercare only | $57.54 | $95.50 | $204.17 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $85.11 Typical High $186.21 | Professional | 56 · Pre-op care only | $51.29 | $85.11 | $186.21 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $776.25 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $467.74 | $776.25 | $1,148.15 |
Where New York sits
The same service costs 24.5 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
$1,000
AK $4,266TX $174
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.