How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,175 to $9,772Professionalmedian $692 · 10th to 90th $550 to $1,413
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 $1,698.24 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,698.24 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,288.25 | Professional | None | $812.83 | $870.96 | $1,288.25 |
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 $575.44 Median $691.83 Typical High $1,258.93 | Professional | None | $575.44 | $691.83 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $426.58 Typical High $794.33 | Professional | 62 · Two surgeons | $363.08 | $426.58 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $109.65 Typical High $204.17 | Professional | 80 · Assistant surgeon | $93.33 | $109.65 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $95.50 Typical High $177.83 | Professional | AS · PA/NP assist | $81.28 | $95.50 | $177.83 |
CDPHP Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
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 $616.60 Median $831.76 Typical High $2,818.38 | Professional | None | $616.60 | $831.76 | $2,818.38 |
Emblem Health Setting Facility Modifier None Typical Low $758.58 Median $1,202.26 Typical High $2,691.53 | Facility | None | $758.58 | $1,202.26 | $2,691.53 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,288.25 | Professional | None | $741.31 | $812.83 | $1,288.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $1,122.02 | Professional | None | $501.19 | $616.60 | $1,122.02 |
MVP Health Care Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $4,786.30 | Facility | None | $776.25 | $776.25 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,778.28 | Professional | None | $977.24 | $977.24 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,344.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,344.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,949.84 | Professional | None | $524.81 | $758.58 | $1,949.84 |
Univera Setting Facility Modifier None Typical Low $588.84 Median $630.96 Typical High $3,019.95 | Facility | None | $588.84 | $630.96 | $3,019.95 |
Univera Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $1,122.02 | Professional | None | $501.19 | $616.60 | $1,122.02 |
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 $407.38 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $407.38 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $162.18 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $616.60 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $123.03 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $81.28 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $602.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $562.34 Typical High $1,023.29 | Professional | 54 · Surgery only | $457.09 | $562.34 | $1,023.29 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $56.23 Typical High $102.33 | Professional | 55 · Aftercare only | $45.71 | $56.23 | $102.33 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $50.12 Typical High $91.20 | Professional | 56 · Pre-op care only | $40.74 | $50.12 | $91.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $512.86 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $416.87 | $512.86 | $933.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $478.63 Typical High $724.44 | Professional | 53 · Discontinued | $363.08 | $478.63 | $724.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $562.34 Typical High $1,023.29 | Professional | 54 · Surgery only | $457.09 | $562.34 | $1,023.29 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $56.23 Typical High $125.89 | Professional | 55 · Aftercare only | $45.71 | $56.23 | $125.89 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $50.12 Typical High $112.20 | Professional | 56 · Pre-op care only | $40.74 | $50.12 | $112.20 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $512.86 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $416.87 | $512.86 | $933.25 |
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· 48th of 51
$724
AK $2,884UT $537
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.