How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,000 to $10,000Professionalmedian $851 · 10th to 90th $676 to $1,820
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 $1,000.00 Median $1,071.52 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,071.52 | $1,659.59 |
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 $724.44 Median $851.14 Typical High $1,621.81 | Professional | None | $724.44 | $851.14 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $537.03 Typical High $1,023.29 | Professional | 62 · Two surgeons | $457.09 | $537.03 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $263.03 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $117.49 Typical High $229.09 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $229.09 |
CDPHP Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $758.58 Median $1,000.00 Typical High $3,801.89 | Professional | None | $758.58 | $1,000.00 | $3,801.89 |
Emblem Health Setting Facility Modifier None Typical Low $933.25 Median $1,479.11 Typical High $3,235.94 | Facility | None | $933.25 | $1,479.11 | $3,235.94 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,584.89 | Professional | None | $851.14 | $977.24 | $1,584.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,412.54 | Professional | None | $616.60 | $758.58 | $1,412.54 |
MVP Health Care Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $4,786.30 | Facility | None | $954.99 | $954.99 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,230.27 | $2,187.76 |
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 $645.65 Median $933.25 Typical High $2,454.71 | Professional | None | $645.65 | $933.25 | $2,454.71 |
Univera Setting Facility Modifier None Typical Low $724.44 Median $776.25 Typical High $3,235.94 | Facility | None | $724.44 | $776.25 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,288.25 | Professional | None | $616.60 | $758.58 | $1,288.25 |
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 $501.19 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $501.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $204.17 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $758.58 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $758.58 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $691.83 Typical High $1,318.26 | Professional | 54 · Surgery only | $562.34 | $691.83 | $1,318.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $69.18 Typical High $128.82 | Professional | 55 · Aftercare only | $56.23 | $69.18 | $128.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $61.66 Typical High $114.82 | Professional | 56 · Pre-op care only | $50.12 | $61.66 | $114.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $630.96 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $512.86 | $630.96 | $1,202.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $588.84 Typical High $891.25 | Professional | 53 · Discontinued | $457.09 | $588.84 | $891.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $691.83 Typical High $1,258.93 | Professional | 54 · Surgery only | $562.34 | $691.83 | $1,258.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $69.18 Typical High $154.88 | Professional | 55 · Aftercare only | $56.23 | $69.18 | $154.88 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $61.66 Typical High $138.04 | Professional | 56 · Pre-op care only | $50.12 | $61.66 | $138.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $630.96 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $512.86 | $630.96 | $1,148.15 |
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· 48th of 51
$891
AK $3,548TX $631
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.