How much rates vary
Facilitymedian $7,244 · 10th to 90th $1,820 to $13,804Professionalmedian $398 · 10th to 90th $324 to $617
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 $1,513.56 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,513.56 | $6,025.60 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | None | $436.52 | $489.78 | $489.78 |
Ambetter Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $741.31 | Professional | None | $380.19 | $380.19 | $741.31 |
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 $338.84 Median $398.11 Typical High $616.60 | Professional | None | $338.84 | $398.11 | $616.60 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $213.80 Median $251.19 Typical High $389.05 | Professional | 62 · Two surgeons | $213.80 | $251.19 | $389.05 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $63.10 Typical High $100.00 | Professional | 80 · Assistant surgeon | $53.70 | $63.10 | $100.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $54.95 Typical High $87.10 | Professional | AS · PA/NP assist | $46.77 | $54.95 | $87.10 |
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 $588.84 Median $588.84 Typical High $588.84 | Professional | None | $588.84 | $588.84 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $13,182.57 | Facility | None | $691.83 | $691.83 | $13,182.57 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $812.83 | Professional | None | $354.81 | $354.81 | $812.83 |
Emblem Health Setting Facility Modifier None Typical Low $416.87 Median $489.78 Typical High $1,548.82 | Facility | None | $416.87 | $489.78 | $1,548.82 |
Emblem Health Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $794.33 | Professional | None | $389.05 | $467.74 | $794.33 |
Excellus BCBS Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $549.54 | Professional | None | $275.42 | $363.08 | $549.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Facility | None | $7,943.28 | $7,943.28 | $7,943.28 |
MVP Health Care Setting Facility Modifier None Typical Low $416.87 Median $6,456.54 Typical High $7,079.46 | Facility | None | $416.87 | $6,456.54 | $7,079.46 |
MVP Health Care Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | None | $501.19 | $501.19 | $575.44 |
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 $295.12 Median $389.05 Typical High $630.96 | Professional | None | $295.12 | $389.05 | $630.96 |
Univera Setting Facility Modifier None Typical Low $263.03 Median $537.03 Typical High $1,288.25 | Facility | None | $263.03 | $537.03 | $1,288.25 |
Univera Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $549.54 | Professional | None | $275.42 | $363.08 | $549.54 |
10 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 $323.59 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $323.59 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $302.00 | $346.74 | $346.74 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $331.13 Typical High $501.19 | Professional | 54 · Surgery only | $199.53 | $331.13 | $501.19 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $36.31 Typical High $54.95 | Professional | 55 · Aftercare only | $22.39 | $36.31 | $54.95 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $36.31 Typical High $54.95 | Professional | 56 · Pre-op care only | $22.39 | $36.31 | $54.95 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $295.12 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $177.83 | $295.12 | $436.52 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $331.13 Typical High $501.19 | Professional | 54 · Surgery only | $199.53 | $331.13 | $501.19 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $36.31 Typical High $79.43 | Professional | 55 · Aftercare only | $22.39 | $36.31 | $79.43 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $36.31 Typical High $79.43 | Professional | 56 · Pre-op care only | $22.39 | $36.31 | $79.43 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $295.12 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $177.83 | $295.12 | $436.52 |
Where New York sits
The same service costs 4.4 times more in Alaska 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· 46th of 51
$398
AK $1,318UT $302
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.