How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,175 to $11,220Professionalmedian $1,413 · 10th to 90th $1,122 to $3,020
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 $1,698.24 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,698.24 | $1,778.28 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,456.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,412.54 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $891.25 Typical High $1,778.28 | Professional | 62 · Two surgeons | $758.58 | $891.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $223.87 Typical High $457.09 | Professional | 80 · Assistant surgeon | $190.55 | $223.87 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $194.98 Typical High $389.05 | Professional | AS · PA/NP assist | $165.96 | $194.98 | $389.05 |
CDPHP Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $1,412.54 Median $1,621.81 Typical High $5,888.44 | Professional | None | $1,412.54 | $1,621.81 | $5,888.44 |
Emblem Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $5,370.32 | Facility | None | $1,202.26 | $1,698.24 | $5,370.32 |
Emblem Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,621.81 | $1,778.28 | $2,884.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,288.25 | $2,290.87 |
MVP Health Care Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $4,786.30 | Facility | None | $1,445.44 | $1,445.44 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $3,801.89 | Professional | None | $1,862.09 | $1,862.09 | $3,801.89 |
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 $1,122.02 Median $1,584.89 Typical High $4,365.16 | Professional | None | $1,122.02 | $1,584.89 | $4,365.16 |
Univera Setting Facility Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $5,011.87 | Facility | None | $1,202.26 | $1,380.38 | $5,011.87 |
Univera Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,288.25 | $2,137.96 |
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 $851.14 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $851.14 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $338.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,258.93 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $251.19 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $169.82 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,258.93 | $1,258.93 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,174.90 Typical High $2,137.96 | Professional | 54 · Surgery only | $933.25 | $1,174.90 | $2,137.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $117.49 Typical High $213.80 | Professional | 55 · Aftercare only | $93.33 | $117.49 | $213.80 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $104.71 Typical High $190.55 | Professional | 56 · Pre-op care only | $81.28 | $104.71 | $190.55 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,071.52 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $851.14 | $1,071.52 | $1,949.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $1,023.29 Typical High $1,479.11 | Professional | 53 · Discontinued | $741.31 | $1,023.29 | $1,479.11 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,174.90 Typical High $2,089.30 | Professional | 54 · Surgery only | $933.25 | $1,174.90 | $2,089.30 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $117.49 Typical High $257.04 | Professional | 55 · Aftercare only | $93.33 | $117.49 | $257.04 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $104.71 Typical High $229.09 | Professional | 56 · Pre-op care only | $81.28 | $104.71 | $229.09 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,071.52 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $851.14 | $1,071.52 | $1,905.46 |
Where New York sits
The same service costs 5.6 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
$1,479
AK $6,026UT $1,072
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.