How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,349 to $10,965Professionalmedian $977 · 10th to 90th $776 to $1,995
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,202.26 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,778.28 | Professional | None | $831.76 | $977.24 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $616.60 Typical High $1,122.02 | Professional | 62 · Two surgeons | $524.81 | $616.60 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $154.88 Typical High $288.40 | Professional | 80 · Assistant surgeon | $131.83 | $154.88 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $134.90 Typical High $251.19 | Professional | AS · PA/NP assist | $114.82 | $134.90 | $251.19 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $4,466.84 Typical High $8,912.51 | Facility | None | $1,621.81 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $3,981.07 | Professional | None | $870.96 | $1,096.48 | $3,981.07 |
Emblem Health Setting Facility Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $3,715.35 | Facility | None | $1,047.13 | $1,862.09 | $3,715.35 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,819.70 | Professional | None | $977.24 | $1,122.02 | $1,819.70 |
Excellus BCBS Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,445.44 | Professional | None | $676.08 | $870.96 | $1,445.44 |
MVP Health Care Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $4,786.30 | Facility | None | $1,122.02 | $1,122.02 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,445.44 | $1,548.82 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,232.93 | Facility | None | $1,230.27 | $3,162.28 | $10,232.93 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $2,754.23 | Professional | None | $691.83 | $1,047.13 | $2,754.23 |
Univera Setting Facility Modifier None Typical Low $575.44 Median $891.25 Typical High $3,630.78 | Facility | None | $575.44 | $891.25 | $3,630.78 |
Univera Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,445.44 | Professional | None | $676.08 | $870.96 | $1,445.44 |
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 $602.56 Median $602.56 Typical High $645.65 | Professional | 52 · Reduced service | $602.56 | $602.56 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $263.03 | Professional | 53 · Discontinued | $239.88 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $977.24 | Professional | 54 · Surgery only | $891.25 | $891.25 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $194.98 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $131.83 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $912.01 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $794.33 Typical High $1,479.11 | Professional | 54 · Surgery only | $616.60 | $794.33 | $1,479.11 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $87.10 Typical High $162.18 | Professional | 55 · Aftercare only | $67.61 | $87.10 | $162.18 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $87.10 Typical High $162.18 | Professional | 56 · Pre-op care only | $67.61 | $87.10 | $162.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $691.83 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $549.54 | $691.83 | $1,288.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $676.08 Typical High $1,023.29 | Professional | 53 · Discontinued | $524.81 | $676.08 | $1,023.29 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $794.33 Typical High $1,318.26 | Professional | 54 · Surgery only | $616.60 | $794.33 | $1,318.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $89.13 Typical High $199.53 | Professional | 55 · Aftercare only | $67.61 | $89.13 | $199.53 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $89.13 Typical High $199.53 | Professional | 56 · Pre-op care only | $67.61 | $89.13 | $199.53 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $707.95 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $549.54 | $707.95 | $1,174.90 |
Where New York sits
The same service costs 5.6 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
$1,023
AK $4,074UT $724
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.