How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,072 to $10,000Professionalmedian $1,259 · 10th to 90th $1,023 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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,412.54 | $1,584.89 | $1,584.89 |
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 $1,230.27 | Professional | 62 · Two surgeons | $691.83 | $812.83 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $208.93 Typical High $316.23 | Professional | 80 · Assistant surgeon | $173.78 | $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 $1,174.90 Median $1,548.82 Typical High $5,011.87 | Facility | None | $1,174.90 | $1,548.82 | $5,011.87 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,513.56 | $2,691.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,737.80 | Professional | None | $891.25 | $1,148.15 | $1,737.80 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,288.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,258.93 | $2,187.76 |
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 $933.25 Median $1,258.93 Typical High $2,041.74 | Professional | None | $933.25 | $1,258.93 | $2,041.74 |
Univera Setting Facility Modifier None Typical Low $851.14 Median $1,258.93 Typical High $3,981.07 | Facility | None | $851.14 | $1,258.93 | $3,981.07 |
Univera Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,737.80 | Professional | None | $891.25 | $1,202.26 | $1,737.80 |
16 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 $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $707.95 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $281.84 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,047.13 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $141.25 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $977.24 | $1,096.48 | $1,096.48 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,071.52 Typical High $1,584.89 | Professional | 54 · Surgery only | $660.69 | $1,071.52 | $1,584.89 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $120.23 Typical High $177.83 | Professional | 55 · Aftercare only | $72.44 | $120.23 | $177.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $107.15 Typical High $158.49 | Professional | 56 · Pre-op care only | $66.07 | $107.15 | $158.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $954.99 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $588.84 | $954.99 | $1,445.44 |
Highmark BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $1,819.70 |
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 $1,584.89 | Professional | 54 · Surgery only | $660.69 | $1,071.52 | $1,584.89 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $120.23 Typical High $281.84 | Professional | 55 · Aftercare only | $72.44 | $120.23 | $281.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $107.15 Typical High $257.04 | Professional | 56 · Pre-op care only | $66.07 | $107.15 | $257.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $954.99 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $588.84 | $954.99 | $1,412.54 |
Where New York sits
The same service costs 5.2 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
$1,259
AK $4,677TX $891
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.