How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,072 to $11,482Professionalmedian $1,072 · 10th to 90th $832 to $2,188
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 $2,238.72 Median $6,456.54 Typical High $13,182.57 | Facility | None | $2,238.72 | $6,456.54 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,380.38 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,380.38 | $2,570.40 |
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 $891.25 Median $1,047.13 Typical High $1,949.84 | Professional | None | $891.25 | $1,047.13 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $1,202.26 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $165.96 Typical High $309.03 | Professional | 80 · Assistant surgeon | $141.25 | $165.96 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $144.54 Typical High $269.15 | Professional | AS · PA/NP assist | $123.03 | $144.54 | $269.15 |
CDPHP Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
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 $933.25 Median $1,230.27 Typical High $4,265.80 | Professional | None | $933.25 | $1,230.27 | $4,265.80 |
Emblem Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,949.84 Typical High $3,981.07 | Facility | None | $1,122.02 | $1,949.84 | $3,981.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,047.13 Median $1,202.26 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,202.26 | $1,949.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,698.24 | Professional | None | $758.58 | $933.25 | $1,698.24 |
MVP Health Care Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $4,786.30 | Facility | None | $1,202.26 | $1,202.26 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,691.53 | Professional | None | $1,412.54 | $1,412.54 | $2,691.53 |
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 $794.33 Median $1,148.15 Typical High $3,019.95 | Professional | None | $794.33 | $1,148.15 | $3,019.95 |
Univera Setting Facility Modifier None Typical Low $891.25 Median $954.99 Typical High $4,466.84 | Facility | None | $891.25 | $954.99 | $4,466.84 |
Univera Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,698.24 | Professional | None | $758.58 | $933.25 | $1,698.24 |
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 $616.60 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $616.60 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $251.19 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $933.25 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $186.21 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $123.03 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $870.96 | $954.99 | $954.99 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $851.14 Typical High $1,548.82 | Professional | 54 · Surgery only | $691.83 | $851.14 | $1,548.82 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $85.11 Typical High $154.88 | Professional | 55 · Aftercare only | $69.18 | $85.11 | $154.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $75.86 Typical High $138.04 | Professional | 56 · Pre-op care only | $61.66 | $75.86 | $138.04 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $776.25 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $630.96 | $776.25 | $1,412.54 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $724.44 Typical High $1,096.48 | Professional | 53 · Discontinued | $562.34 | $724.44 | $1,096.48 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $851.14 Typical High $1,548.82 | Professional | 54 · Surgery only | $691.83 | $851.14 | $1,548.82 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $85.11 Typical High $190.55 | Professional | 55 · Aftercare only | $69.18 | $85.11 | $190.55 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $75.86 Typical High $169.82 | Professional | 56 · Pre-op care only | $61.66 | $75.86 | $169.82 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $776.25 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $630.96 | $776.25 | $1,412.54 |
Where New York sits
The same service costs 5.9 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
$1,096
AK $4,365TX $741
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.