How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,175 to $11,220Professionalmedian $1,862 · 10th to 90th $1,445 to $3,715
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 $2,187.76 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,187.76 | $2,290.87 | $2,290.87 |
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 $1,548.82 Median $1,819.70 Typical High $3,388.44 | Professional | None | $1,548.82 | $1,819.70 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,148.15 Typical High $2,137.96 | Professional | 62 · Two surgeons | $977.24 | $1,148.15 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $288.40 Typical High $537.03 | Professional | 80 · Assistant surgeon | $245.47 | $288.40 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $257.04 Typical High $467.74 | Professional | AS · PA/NP assist | $218.78 | $257.04 | $467.74 |
CDPHP Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,019.95 | Facility | None | $851.14 | $1,778.28 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $7,413.10 | Professional | None | $1,621.81 | $2,041.74 | $7,413.10 |
Emblem Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $6,456.54 | Facility | None | $1,202.26 | $1,949.84 | $6,456.54 |
Emblem Health Setting Professional Modifier None Typical Low $1,905.46 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,905.46 | $2,089.30 | $3,388.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $3,019.95 | Professional | None | $1,318.26 | $1,621.81 | $3,019.95 |
MVP Health Care Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $4,786.30 | Facility | None | $2,041.74 | $2,041.74 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $4,677.35 | Professional | None | $2,511.89 | $2,511.89 | $4,677.35 |
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 $1,380.38 Median $1,995.26 Typical High $5,248.07 | Professional | None | $1,380.38 | $1,995.26 | $5,248.07 |
Univera Setting Facility Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $6,606.93 | Facility | None | $1,548.82 | $1,659.59 | $6,606.93 |
Univera Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,621.81 | $2,754.23 |
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 $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,071.52 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $436.52 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,621.81 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $323.59 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $218.78 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,621.81 | $1,621.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,479.11 Typical High $2,818.38 | Professional | 54 · Surgery only | $1,202.26 | $1,479.11 | $2,818.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $144.54 Typical High $275.42 | Professional | 55 · Aftercare only | $120.23 | $144.54 | $275.42 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $128.82 Typical High $245.47 | Professional | 56 · Pre-op care only | $107.15 | $128.82 | $245.47 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,348.96 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,348.96 | $2,570.40 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $977.24 Median $1,258.93 Typical High $1,905.46 | Professional | 53 · Discontinued | $977.24 | $1,258.93 | $1,905.46 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,479.11 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,202.26 | $1,479.11 | $2,691.53 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $144.54 Typical High $331.13 | Professional | 55 · Aftercare only | $120.23 | $144.54 | $331.13 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $128.82 Typical High $295.12 | Professional | 56 · Pre-op care only | $107.15 | $128.82 | $295.12 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,348.96 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,348.96 | $2,454.71 |
Where New York sits
The same service costs 6.0 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
$1,905
AK $7,586TX $1,259
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.