How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,413 to $13,804Professionalmedian $437 · 10th to 90th $331 to $575
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 $501.19 Median $5,495.41 Typical High $11,748.98 | Facility | None | $501.19 | $5,495.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $501.19 | Professional | None | $407.38 | $457.09 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $309.03 Median $354.81 Typical High $707.95 | Professional | None | $309.03 | $354.81 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $8,128.31 Typical High $14,791.08 | Facility | None | $4,570.88 | $8,128.31 | $14,791.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $575.44 | Professional | None | $371.54 | $436.52 | $575.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $275.42 Typical High $363.08 | Professional | 62 · Two surgeons | $234.42 | $275.42 | $363.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $69.18 Typical High $93.33 | Professional | 80 · Assistant surgeon | $58.88 | $69.18 | $93.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $61.66 Typical High $81.28 | Professional | AS · PA/NP assist | $51.29 | $61.66 | $81.28 |
CDPHP Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $10,964.78 | Facility | None | $3,630.78 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $13,182.57 | Facility | None | $645.65 | $645.65 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $776.25 | Professional | None | $331.13 | $331.13 | $776.25 |
Emblem Health Setting Facility Modifier None Typical Low $398.11 Median $457.09 Typical High $1,445.44 | Facility | None | $398.11 | $457.09 | $1,445.44 |
Emblem Health Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $758.58 | Professional | None | $363.08 | $436.52 | $758.58 |
Excellus BCBS Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Excellus BCBS Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $512.86 | Professional | None | $257.04 | $331.13 | $512.86 |
Highmark BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $6,606.93 Typical High $9,772.37 | Facility | None | $5,011.87 | $6,606.93 | $9,772.37 |
Highmark BCBS Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
MVP Health Care Setting Facility Modifier None Typical Low $389.05 Median $6,456.54 Typical High $7,079.46 | Facility | None | $389.05 | $6,456.54 | $7,079.46 |
MVP Health Care Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $549.54 | Professional | None | $467.74 | $467.74 | $549.54 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $6,760.83 Typical High $14,791.08 | Facility | None | $2,398.83 | $6,760.83 | $14,791.08 |
United Setting Professional Modifier None Typical Low $275.42 Median $371.54 Typical High $588.84 | Professional | None | $275.42 | $371.54 | $588.84 |
Univera Setting Facility Modifier None Typical Low $245.47 Median $501.19 Typical High $1,202.26 | Facility | None | $245.47 | $501.19 | $1,202.26 |
Univera Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $501.19 | Professional | None | $257.04 | $346.74 | $501.19 |
11 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 54 · Surgery only Typical Low $302.00 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $302.00 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $281.84 | $323.59 | $323.59 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $309.03 Typical High $457.09 | Professional | 54 · Surgery only | $186.21 | $309.03 | $457.09 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $34.67 Typical High $51.29 | Professional | 55 · Aftercare only | $20.89 | $34.67 | $51.29 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $34.67 Typical High $51.29 | Professional | 56 · Pre-op care only | $20.89 | $34.67 | $51.29 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $275.42 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $165.96 | $275.42 | $407.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $269.15 Typical High $380.19 | Professional | 53 · Discontinued | $204.17 | $269.15 | $380.19 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $309.03 Typical High $457.09 | Professional | 54 · Surgery only | $186.21 | $309.03 | $457.09 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $34.67 Typical High $81.28 | Professional | 55 · Aftercare only | $20.89 | $34.67 | $81.28 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $34.67 Typical High $81.28 | Professional | 56 · Pre-op care only | $20.89 | $34.67 | $81.28 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $275.42 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $165.96 | $275.42 | $407.38 |
Where New York sits
The same service costs 4.2 times more in Wyoming than in Utah. 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· 35th of 51
$437
WY $1,202UT $288
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.