How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,072 to $10,233Professionalmedian $1,259 · 10th to 90th $1,000 to $1,950
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 $1,380.38 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,380.38 | $1,548.82 | $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 $1,071.52 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,258.93 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $794.33 Typical High $1,202.26 | Professional | 62 · Two surgeons | $676.08 | $794.33 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $199.53 Typical High $309.03 | Professional | 80 · Assistant surgeon | $169.82 | $199.53 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $177.83 Typical High $269.15 | Professional | AS · PA/NP assist | $151.36 | $177.83 | $269.15 |
CDPHP Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $1,122.02 Median $1,122.02 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,122.02 | $2,511.89 |
Emblem Health Setting Facility Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $4,897.79 | Facility | None | $1,230.27 | $1,513.56 | $4,897.79 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,479.11 | $2,630.27 |
Excellus BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,737.80 | Professional | None | $870.96 | $1,122.02 | $1,737.80 |
MVP Health Care Setting Facility Modifier None Typical Low $1,258.93 Median $5,754.40 Typical High $41,686.94 | Facility | None | $1,258.93 | $5,754.40 | $41,686.94 |
MVP Health Care Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,348.96 | $2,137.96 |
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 $912.01 Median $1,230.27 Typical High $1,995.26 | Professional | None | $912.01 | $1,230.27 | $1,995.26 |
Univera Setting Facility Modifier None Typical Low $831.76 Median $1,230.27 Typical High $4,168.69 | Facility | None | $831.76 | $1,230.27 | $4,168.69 |
Univera Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,698.24 | Professional | None | $870.96 | $1,174.90 | $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 $691.83 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $691.83 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $275.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,023.29 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $204.17 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $138.04 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $954.99 | $1,071.52 | $1,071.52 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $1,047.13 Typical High $1,548.82 | Professional | 54 · Surgery only | $630.96 | $1,047.13 | $1,548.82 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $117.49 Typical High $173.78 | Professional | 55 · Aftercare only | $70.79 | $117.49 | $173.78 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $104.71 Typical High $154.88 | Professional | 56 · Pre-op care only | $63.10 | $104.71 | $154.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $954.99 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $575.44 | $954.99 | $1,380.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $912.01 Typical High $1,258.93 | Professional | 53 · Discontinued | $676.08 | $912.01 | $1,258.93 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $1,047.13 Typical High $1,548.82 | Professional | 54 · Surgery only | $630.96 | $1,047.13 | $1,548.82 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $117.49 Typical High $275.42 | Professional | 55 · Aftercare only | $70.79 | $117.49 | $275.42 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $104.71 Typical High $251.19 | Professional | 56 · Pre-op care only | $63.10 | $104.71 | $251.19 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $954.99 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $575.44 | $954.99 | $1,380.38 |
Where New York sits
The same service costs 21.4 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
$1,259
AK $4,571TX $214
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.