How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,072 to $8,128Professionalmedian $589 · 10th to 90th $457 to $1,175
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,412.54 | Professional | None | $676.08 | $724.44 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $1,071.52 | Professional | None | $489.78 | $575.44 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $302.00 Median $363.08 Typical High $660.69 | Professional | 62 · Two surgeons | $302.00 | $363.08 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $91.20 Typical High $169.82 | Professional | 80 · Assistant surgeon | $77.62 | $91.20 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $79.43 Typical High $147.91 | Professional | AS · PA/NP assist | $67.61 | $79.43 | $147.91 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,884.03 Typical High $5,888.44 | Facility | None | $1,348.96 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $2,344.23 | Professional | None | $512.86 | $724.44 | $2,344.23 |
Emblem Health Setting Facility Modifier None Typical Low $630.96 Median $831.76 Typical High $2,238.72 | Facility | None | $630.96 | $831.76 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $616.60 Median $676.08 Typical High $1,096.48 | Professional | None | $616.60 | $676.08 | $1,096.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $954.99 | Professional | None | $426.58 | $524.81 | $954.99 |
MVP Health Care Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $4,786.30 | Facility | None | $645.65 | $645.65 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,479.11 | Professional | None | $851.14 | $851.14 | $1,479.11 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,943.28 | Facility | None | $1,122.02 | $2,754.23 | $7,943.28 |
United Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $1,659.59 | Professional | None | $446.68 | $630.96 | $1,659.59 |
Univera Setting Facility Modifier None Typical Low $501.19 Median $524.81 Typical High $2,398.83 | Facility | None | $501.19 | $524.81 | $2,398.83 |
Univera Setting Professional Modifier None Typical Low $426.58 Median $524.81 Typical High $954.99 | Professional | None | $426.58 | $524.81 | $954.99 |
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 $338.84 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $338.84 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $512.86 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $478.63 | $512.86 | $512.86 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $478.63 Typical High $870.96 | Professional | 54 · Surgery only | $380.19 | $478.63 | $870.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $46.77 Typical High $85.11 | Professional | 55 · Aftercare only | $38.02 | $46.77 | $85.11 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $41.69 Typical High $75.86 | Professional | 56 · Pre-op care only | $33.88 | $41.69 | $75.86 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $436.52 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $346.74 | $436.52 | $794.33 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $398.11 Typical High $602.56 | Professional | 53 · Discontinued | $302.00 | $398.11 | $602.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $478.63 Typical High $870.96 | Professional | 54 · Surgery only | $380.19 | $478.63 | $870.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $46.77 Typical High $104.71 | Professional | 55 · Aftercare only | $38.02 | $46.77 | $104.71 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $41.69 Typical High $93.33 | Professional | 56 · Pre-op care only | $33.88 | $41.69 | $93.33 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $436.52 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $346.74 | $436.52 | $794.33 |
Where New York sits
The same service costs 5.4 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· 49th of 51
$603
AK $2,399UT $447
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.