How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,413 to $20,893Professionalmedian $759 · 10th to 90th $603 to $1,585
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 $5,248.07 Typical High $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $1,862.09 | Professional | None | $912.01 | $954.99 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $20,892.96 | Facility | None | $1,862.09 | $8,709.64 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,412.54 | Professional | None | $630.96 | $741.31 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $467.74 Typical High $891.25 | Professional | 62 · Two surgeons | $398.11 | $467.74 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $120.23 Typical High $223.87 | Professional | 80 · Assistant surgeon | $102.33 | $120.23 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $104.71 Typical High $199.53 | Professional | AS · PA/NP assist | $89.13 | $104.71 | $199.53 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $27,542.29 Typical High $50,118.72 | Facility | None | $1,258.93 | $27,542.29 | $50,118.72 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $3,090.30 | Professional | None | $691.83 | $851.14 | $3,090.30 |
Emblem Health Setting Facility Modifier None Typical Low $831.76 Median $1,288.25 Typical High $2,951.21 | Facility | None | $831.76 | $1,288.25 | $2,951.21 |
Emblem Health Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,445.44 | Professional | None | $812.83 | $891.25 | $1,445.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,258.93 | Professional | None | $562.34 | $691.83 | $1,258.93 |
MVP Health Care Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $4,786.30 | Facility | None | $870.96 | $870.96 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,949.84 | Professional | None | $776.25 | $776.25 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,380.38 Median $4,677.35 Typical High $16,595.87 | Facility | None | $1,380.38 | $4,677.35 | $16,595.87 |
United Setting Professional Modifier None Typical Low $588.84 Median $831.76 Typical High $2,187.76 | Professional | None | $588.84 | $831.76 | $2,187.76 |
Univera Setting Facility Modifier None Typical Low $660.69 Median $707.95 Typical High $2,754.23 | Facility | None | $660.69 | $707.95 | $2,754.23 |
Univera Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,258.93 | Professional | None | $562.34 | $691.83 | $1,258.93 |
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 $457.09 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $457.09 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $181.97 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $676.08 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $91.20 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $630.96 | $676.08 | $676.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $630.96 Typical High $1,174.90 | Professional | 54 · Surgery only | $512.86 | $630.96 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $61.66 Typical High $117.49 | Professional | 55 · Aftercare only | $50.12 | $61.66 | $117.49 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $54.95 Typical High $104.71 | Professional | 56 · Pre-op care only | $44.67 | $54.95 | $104.71 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $575.44 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $467.74 | $575.44 | $1,071.52 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $537.03 Typical High $794.33 | Professional | 53 · Discontinued | $407.38 | $537.03 | $794.33 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $630.96 Typical High $1,148.15 | Professional | 54 · Surgery only | $512.86 | $630.96 | $1,148.15 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $61.66 Typical High $141.25 | Professional | 55 · Aftercare only | $50.12 | $61.66 | $141.25 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $54.95 Typical High $125.89 | Professional | 56 · Pre-op care only | $44.67 | $54.95 | $125.89 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $575.44 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $467.74 | $575.44 | $1,047.13 |
Where New York sits
The same service costs 6.8 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
$794
AK $3,715TX $550
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.