How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,230 to $11,220Professionalmedian $525 · 10th to 90th $417 to $1,349
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $660.69 Typical High $1,584.89 | Professional | None | $478.63 | $660.69 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,309.57 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $977.24 | Professional | None | $426.58 | $501.19 | $977.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $269.15 Median $316.23 Typical High $616.60 | Professional | 62 · Two surgeons | $269.15 | $316.23 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $81.28 Typical High $158.49 | Professional | 80 · Assistant surgeon | $67.61 | $81.28 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $70.79 Typical High $138.04 | Professional | AS · PA/NP assist | $60.26 | $70.79 | $138.04 |
CDPHP Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
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 $524.81 Median $602.56 Typical High $1,949.84 | Professional | None | $524.81 | $602.56 | $1,949.84 |
Emblem Health Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $2,089.30 | Facility | None | $588.84 | $851.14 | $2,089.30 |
Emblem Health Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $1,023.29 | Professional | None | $588.84 | $660.69 | $1,023.29 |
Excellus BCBS Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $794.33 | Professional | None | $380.19 | $478.63 | $794.33 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $776.25 Median $2,884.03 Typical High $2,884.03 | Professional | None | $776.25 | $2,884.03 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $2,884.03 Typical High $9,332.54 | Facility | None | $1,230.27 | $2,884.03 | $9,332.54 |
United Setting Professional Modifier None Typical Low $407.38 Median $691.83 Typical High $1,412.54 | Professional | None | $407.38 | $691.83 | $1,412.54 |
Univera Setting Facility Modifier None Typical Low $407.38 Median $416.87 Typical High $1,819.70 | Facility | None | $407.38 | $416.87 | $1,819.70 |
Univera Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $758.58 | Professional | None | $380.19 | $478.63 | $758.58 |
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 $239.88 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $239.88 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $97.72 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $363.08 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $72.44 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $47.86 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $338.84 | $457.09 | $457.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $416.87 Typical High $707.95 | Professional | 54 · Surgery only | $323.59 | $416.87 | $707.95 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $67.61 Typical High $114.82 | Professional | 55 · Aftercare only | $52.48 | $67.61 | $114.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $57.54 Typical High $97.72 | Professional | 56 · Pre-op care only | $45.71 | $57.54 | $97.72 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $354.81 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $281.84 | $354.81 | $602.56 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $363.08 Typical High $562.34 | Professional | 53 · Discontinued | $275.42 | $363.08 | $562.34 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $416.87 Typical High $691.83 | Professional | 54 · Surgery only | $323.59 | $416.87 | $691.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $69.18 Typical High $154.88 | Professional | 55 · Aftercare only | $52.48 | $69.18 | $154.88 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $58.88 Typical High $131.83 | Professional | 56 · Pre-op care only | $45.71 | $58.88 | $131.83 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $363.08 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $281.84 | $363.08 | $588.84 |
Where New York sits
The same service costs 6.0 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
$550
AK $2,239UT $372
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.