How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,023 to $10,000Professionalmedian $1,122 · 10th to 90th $891 to $2,291
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 $1,318.26 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,318.26 | $1,412.54 | $2,089.30 |
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 $2,041.74 | Professional | None | $933.25 | $1,096.48 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $691.83 Typical High $1,288.25 | Professional | 62 · Two surgeons | $588.84 | $691.83 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $177.83 Typical High $331.13 | Professional | 80 · Assistant surgeon | $151.36 | $177.83 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $154.88 Typical High $288.40 | Professional | AS · PA/NP assist | $131.83 | $154.88 | $288.40 |
CDPHP Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $1,000.00 Median $1,230.27 Typical High $4,466.84 | Professional | None | $1,000.00 | $1,230.27 | $4,466.84 |
Emblem Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $3,981.07 | Facility | None | $1,202.26 | $1,862.09 | $3,981.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,258.93 | $2,089.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,819.70 | Professional | None | $812.83 | $1,000.00 | $1,819.70 |
MVP Health Care Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $4,786.30 | Facility | None | $1,258.93 | $1,258.93 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,818.38 | Professional | None | $1,621.81 | $1,621.81 | $2,818.38 |
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 $831.76 Median $1,202.26 Typical High $3,162.28 | Professional | None | $831.76 | $1,202.26 | $3,162.28 |
Univera Setting Facility Modifier None Typical Low $954.99 Median $1,023.29 Typical High $4,168.69 | Facility | None | $954.99 | $1,023.29 | $4,168.69 |
Univera Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,819.70 | Professional | None | $812.83 | $1,000.00 | $1,819.70 |
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 $660.69 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $660.69 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $263.03 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $1,000.00 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $199.53 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $131.83 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $933.25 | $977.24 | $977.24 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $912.01 Typical High $1,698.24 | Professional | 54 · Surgery only | $741.31 | $912.01 | $1,698.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $89.13 Typical High $169.82 | Professional | 55 · Aftercare only | $72.44 | $89.13 | $169.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $79.43 Typical High $151.36 | Professional | 56 · Pre-op care only | $64.57 | $79.43 | $151.36 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $831.76 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $676.08 | $831.76 | $1,548.82 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $776.25 Typical High $1,174.90 | Professional | 53 · Discontinued | $588.84 | $776.25 | $1,174.90 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $912.01 Typical High $1,659.59 | Professional | 54 · Surgery only | $741.31 | $912.01 | $1,659.59 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $89.13 Typical High $204.17 | Professional | 55 · Aftercare only | $72.44 | $89.13 | $204.17 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $79.43 Typical High $181.97 | Professional | 56 · Pre-op care only | $64.57 | $79.43 | $181.97 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $831.76 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $676.08 | $831.76 | $1,513.56 |
Where New York sits
The same service costs 5.8 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· 47th of 51
$1,175
AK $4,677TX $813
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.