How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,072 to $10,000Professionalmedian $1,096 · 10th to 90th $891 to $1,698
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 $1,174.90 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,174.90 | $1,318.26 | $1,318.26 |
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 $933.25 Median $1,096.48 Typical High $1,698.24 | Professional | None | $933.25 | $1,096.48 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $691.83 Typical High $1,047.13 | Professional | 62 · Two surgeons | $575.44 | $691.83 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $173.78 Typical High $269.15 | Professional | 80 · Assistant surgeon | $147.91 | $173.78 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $234.42 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $234.42 |
CDPHP Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $977.24 Median $977.24 Typical High $2,187.76 | Professional | None | $977.24 | $977.24 | $2,187.76 |
Emblem Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $4,168.69 | Facility | None | $1,202.26 | $1,380.38 | $4,168.69 |
Emblem Health Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,258.93 | $2,238.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,513.56 | Professional | None | $758.58 | $1,000.00 | $1,513.56 |
MVP Health Care Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $4,786.30 | Facility | None | $1,122.02 | $1,122.02 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,513.56 | $1,513.56 | $1,862.09 |
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 $794.33 Median $1,071.52 Typical High $1,737.80 | Professional | None | $794.33 | $1,071.52 | $1,737.80 |
Univera Setting Facility Modifier None Typical Low $724.44 Median $1,071.52 Typical High $4,365.16 | Facility | None | $724.44 | $1,071.52 | $4,365.16 |
Univera Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,513.56 | Professional | None | $758.58 | $1,000.00 | $1,513.56 |
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 $588.84 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $588.84 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $891.25 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $177.83 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $117.49 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $831.76 | $933.25 | $933.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $891.25 Typical High $1,380.38 | Professional | 54 · Surgery only | $549.54 | $891.25 | $1,380.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $100.00 Typical High $151.36 | Professional | 55 · Aftercare only | $61.66 | $100.00 | $151.36 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $89.13 Typical High $138.04 | Professional | 56 · Pre-op care only | $54.95 | $89.13 | $138.04 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $812.83 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $501.19 | $812.83 | $1,230.27 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $794.33 Typical High $1,071.52 | Professional | 53 · Discontinued | $588.84 | $794.33 | $1,071.52 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $891.25 Typical High $1,380.38 | Professional | 54 · Surgery only | $549.54 | $891.25 | $1,380.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $100.00 Typical High $218.78 | Professional | 55 · Aftercare only | $61.66 | $100.00 | $218.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $89.13 Typical High $199.53 | Professional | 56 · Pre-op care only | $54.95 | $89.13 | $199.53 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $812.83 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $501.19 | $812.83 | $1,230.27 |
Where New York sits
The same service costs 5.6 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· 46th of 51
$1,096
AK $4,266TX $759
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.