How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,047 to $10,233Professionalmedian $1,096 · 10th to 90th $891 to $1,698
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 $1,202.26 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,202.26 | $1,380.38 | $1,380.38 |
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 $933.25 Median $1,096.48 Typical High $1,737.80 | Professional | None | $933.25 | $1,096.48 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $691.83 Typical High $1,071.52 | Professional | 62 · Two surgeons | $588.84 | $691.83 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $177.83 Typical High $269.15 | Professional | 80 · Assistant surgeon | $151.36 | $177.83 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $154.88 Typical High $234.42 | Professional | AS · PA/NP assist | $131.83 | $154.88 | $234.42 |
CDPHP Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $977.24 Median $977.24 Typical High $2,238.72 | Professional | None | $977.24 | $977.24 | $2,238.72 |
Emblem Health Setting Facility Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $4,365.16 | Facility | None | $1,096.48 | $1,348.96 | $4,365.16 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,318.26 | $2,290.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,548.82 | Professional | None | $776.25 | $1,023.29 | $1,548.82 |
MVP Health Care Setting Facility Modifier None Typical Low $1,096.48 Median $5,754.40 Typical High $41,686.94 | Facility | None | $1,096.48 | $5,754.40 | $41,686.94 |
MVP Health Care Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,174.90 | $1,862.09 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,606.93 | Facility | None | $575.44 | $1,778.28 | $6,606.93 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,737.80 | Professional | None | $794.33 | $1,096.48 | $1,737.80 |
Univera Setting Facility Modifier None Typical Low $741.31 Median $1,096.48 Typical High $3,548.13 | Facility | None | $741.31 | $1,096.48 | $3,548.13 |
Univera Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,548.82 | Professional | None | $776.25 | $1,023.29 | $1,548.82 |
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 $602.56 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $602.56 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $239.88 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $912.01 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $181.97 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $120.23 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $851.14 | $954.99 | $954.99 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $933.25 Typical High $1,380.38 | Professional | 54 · Surgery only | $562.34 | $933.25 | $1,380.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $102.33 Typical High $154.88 | Professional | 55 · Aftercare only | $61.66 | $102.33 | $154.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $93.33 Typical High $138.04 | Professional | 56 · Pre-op care only | $56.23 | $93.33 | $138.04 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $831.76 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $501.19 | $831.76 | $1,258.93 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $812.83 Typical High $1,096.48 | Professional | 53 · Discontinued | $602.56 | $812.83 | $1,096.48 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $933.25 Typical High $1,380.38 | Professional | 54 · Surgery only | $562.34 | $933.25 | $1,380.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $102.33 Typical High $223.87 | Professional | 55 · Aftercare only | $61.66 | $102.33 | $223.87 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $93.33 Typical High $199.53 | Professional | 56 · Pre-op care only | $56.23 | $93.33 | $199.53 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $831.76 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $501.19 | $831.76 | $1,258.93 |
Where New York sits
The same service costs 5.6 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
$1,096
AK $4,266TX $759
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.