How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,479 to $11,482Professionalmedian $1,349 · 10th to 90th $1,096 to $2,818
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 $1,659.59 Median $1,659.59 Typical High $3,548.13 | Professional | None | $1,659.59 | $1,659.59 | $3,548.13 |
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 $1,148.15 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,148.15 | $1,348.96 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $851.14 Typical High $1,584.89 | Professional | 62 · Two surgeons | $724.44 | $851.14 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $218.78 Typical High $398.11 | Professional | 80 · Assistant surgeon | $186.21 | $218.78 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $190.55 Typical High $354.81 | Professional | AS · PA/NP assist | $162.18 | $190.55 | $354.81 |
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 $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $4,466.84 Typical High $8,912.51 | Facility | None | $1,778.28 | $4,466.84 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $5,495.41 | Professional | None | $1,230.27 | $1,513.56 | $5,495.41 |
Emblem Health Setting Facility Modifier None Typical Low $1,479.11 Median $2,630.27 Typical High $5,128.61 | Facility | None | $1,479.11 | $2,630.27 | $5,128.61 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,548.82 | $2,511.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,041.74 | Professional | None | $954.99 | $1,230.27 | $2,041.74 |
MVP Health Care Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $4,786.30 | Facility | None | $1,621.81 | $1,621.81 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $3,467.37 | Professional | None | $1,995.26 | $2,137.96 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $11,748.98 | Facility | None | $1,318.26 | $3,548.13 | $11,748.98 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $3,801.89 | Professional | None | $954.99 | $1,479.11 | $3,801.89 |
Univera Setting Facility Modifier None Typical Low $812.83 Median $1,258.93 Typical High $5,248.07 | Facility | None | $812.83 | $1,258.93 | $5,248.07 |
Univera Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $2,041.74 | Professional | None | $954.99 | $1,230.27 | $2,041.74 |
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 $831.76 Median $831.76 Typical High $912.01 | Professional | 52 · Reduced service | $831.76 | $831.76 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $363.08 | Professional | 53 · Discontinued | $331.13 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $251.19 Typical High $275.42 | Professional | 55 · Aftercare only | $251.19 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $181.97 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,288.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,096.48 Typical High $2,041.74 | Professional | 54 · Surgery only | $851.14 | $1,096.48 | $2,041.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $120.23 Typical High $229.09 | Professional | 55 · Aftercare only | $95.50 | $120.23 | $229.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $120.23 Typical High $229.09 | Professional | 56 · Pre-op care only | $95.50 | $120.23 | $229.09 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $977.24 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $758.58 | $977.24 | $1,819.70 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $954.99 Typical High $1,412.54 | Professional | 53 · Discontinued | $724.44 | $954.99 | $1,412.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,122.02 Typical High $1,819.70 | Professional | 54 · Surgery only | $851.14 | $1,122.02 | $1,819.70 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $123.03 Typical High $275.42 | Professional | 55 · Aftercare only | $95.50 | $123.03 | $275.42 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $123.03 Typical High $275.42 | Professional | 56 · Pre-op care only | $95.50 | $123.03 | $275.42 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,000.00 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $758.58 | $1,000.00 | $1,621.81 |
Where New York sits
The same service costs 5.8 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· 47th of 51
$1,445
AK $5,623UT $977
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.