How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,072 to $10,233Professionalmedian $1,288 · 10th to 90th $1,047 to $1,995
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 $1,412.54 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,412.54 | $1,621.81 | $1,621.81 |
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 $1,096.48 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,288.25 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $812.83 Typical High $1,258.93 | Professional | 62 · Two surgeons | $691.83 | $812.83 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $208.93 Typical High $316.23 | Professional | 80 · Assistant surgeon | $177.83 | $208.93 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $181.97 Typical High $275.42 | Professional | AS · PA/NP assist | $154.88 | $181.97 | $275.42 |
CDPHP Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $1,148.15 Median $1,148.15 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,148.15 | $2,630.27 |
Emblem Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $5,011.87 | Facility | None | $1,288.25 | $1,548.82 | $5,011.87 |
Emblem Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,513.56 | $2,691.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,819.70 | Professional | None | $912.01 | $1,202.26 | $1,819.70 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $5,754.40 Typical High $41,686.94 | Facility | None | $1,288.25 | $5,754.40 | $41,686.94 |
MVP Health Care Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,412.54 | $1,412.54 | $2,187.76 |
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 $933.25 Median $1,288.25 Typical High $2,041.74 | Professional | None | $933.25 | $1,288.25 | $2,041.74 |
Univera Setting Facility Modifier None Typical Low $851.14 Median $1,288.25 Typical High $4,168.69 | Facility | None | $851.14 | $1,288.25 | $4,168.69 |
Univera Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,819.70 | Professional | None | $912.01 | $1,202.26 | $1,819.70 |
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 $707.95 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $707.95 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $281.84 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,071.52 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $213.80 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $141.25 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,122.02 | $1,122.02 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,071.52 Typical High $1,621.81 | Professional | 54 · Surgery only | $660.69 | $1,071.52 | $1,621.81 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $120.23 Typical High $181.97 | Professional | 55 · Aftercare only | $72.44 | $120.23 | $181.97 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $107.15 Typical High $162.18 | Professional | 56 · Pre-op care only | $66.07 | $107.15 | $162.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $977.24 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $588.84 | $977.24 | $1,479.11 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $933.25 Typical High $1,288.25 | Professional | 53 · Discontinued | $707.95 | $933.25 | $1,288.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,071.52 Typical High $1,621.81 | Professional | 54 · Surgery only | $660.69 | $1,071.52 | $1,621.81 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $120.23 Typical High $263.03 | Professional | 55 · Aftercare only | $72.44 | $120.23 | $263.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $107.15 Typical High $234.42 | Professional | 56 · Pre-op care only | $66.07 | $107.15 | $234.42 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $977.24 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $588.84 | $977.24 | $1,479.11 |
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
$1,288
AK $4,677TX $871
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.