How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,122 to $11,482Professionalmedian $1,549 · 10th to 90th $1,230 to $3,162
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,905.46 | $1,905.46 | $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 $1,318.26 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,318.26 | $1,548.82 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $977.24 Typical High $1,778.28 | Professional | 62 · Two surgeons | $831.76 | $977.24 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $245.47 Typical High $457.09 | Professional | 80 · Assistant surgeon | $208.93 | $245.47 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $213.80 Typical High $398.11 | Professional | AS · PA/NP assist | $181.97 | $213.80 | $398.11 |
CDPHP Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
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 $1,380.38 Median $1,737.80 Typical High $6,309.57 | Professional | None | $1,380.38 | $1,737.80 | $6,309.57 |
Emblem Health Setting Facility Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $5,495.41 | Facility | None | $1,548.82 | $1,905.46 | $5,495.41 |
Emblem Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,513.56 | $1,737.80 | $2,884.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,380.38 | $2,290.87 |
MVP Health Care Setting Facility Modifier None Typical Low $1,737.80 Median $4,786.30 Typical High $23,442.29 | Facility | None | $1,737.80 | $4,786.30 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $3,981.07 | Professional | None | $2,238.72 | $2,238.72 | $3,981.07 |
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 $1,096.48 Median $1,659.59 Typical High $4,365.16 | Professional | None | $1,096.48 | $1,659.59 | $4,365.16 |
Univera Setting Facility Modifier None Typical Low $912.01 Median $1,412.54 Typical High $5,623.41 | Facility | None | $912.01 | $1,412.54 | $5,623.41 |
Univera Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,380.38 | $2,290.87 |
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 $954.99 Median $954.99 Typical High $1,047.13 | Professional | 52 · Reduced service | $954.99 | $954.99 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $416.87 | Professional | 53 · Discontinued | $380.19 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $309.03 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $208.93 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,445.44 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,230.27 Typical High $2,344.23 | Professional | 54 · Surgery only | $977.24 | $1,230.27 | $2,344.23 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $138.04 Typical High $257.04 | Professional | 55 · Aftercare only | $107.15 | $138.04 | $257.04 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $138.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $107.15 | $138.04 | $257.04 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,096.48 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $870.96 | $1,096.48 | $2,041.74 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $1,071.52 Typical High $1,621.81 | Professional | 53 · Discontinued | $831.76 | $1,071.52 | $1,621.81 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,258.93 Typical High $2,089.30 | Professional | 54 · Surgery only | $977.24 | $1,258.93 | $2,089.30 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $141.25 Typical High $316.23 | Professional | 55 · Aftercare only | $107.15 | $141.25 | $316.23 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $141.25 Typical High $316.23 | Professional | 56 · Pre-op care only | $107.15 | $141.25 | $316.23 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,122.02 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $870.96 | $1,122.02 | $1,862.09 |
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· 44th of 51
$1,622
AK $6,457TX $1,096
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.