How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,259 to $10,965Professionalmedian $589 · 10th to 90th $468 to $1,549
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 $1,621.81 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,621.81 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $741.31 Typical High $1,445.44 | Professional | None | $537.03 | $741.31 | $1,445.44 |
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 $478.63 Median $562.34 Typical High $1,148.15 | Professional | None | $478.63 | $562.34 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $302.00 Median $354.81 Typical High $691.83 | Professional | 62 · Two surgeons | $302.00 | $354.81 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $89.13 Typical High $181.97 | Professional | 80 · Assistant surgeon | $75.86 | $89.13 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $77.62 Typical High $162.18 | Professional | AS · PA/NP assist | $66.07 | $77.62 | $162.18 |
CDPHP Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $10,964.78 | Facility | None | $3,630.78 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $3,890.45 Typical High $7,762.47 | Facility | None | $1,445.44 | $3,890.45 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $2,290.87 | Professional | None | $602.56 | $645.65 | $2,290.87 |
Emblem Health Setting Facility Modifier None Typical Low $645.65 Median $1,348.96 Typical High $2,511.89 | Facility | None | $645.65 | $1,348.96 | $2,511.89 |
Emblem Health Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $1,122.02 | Professional | None | $602.56 | $676.08 | $1,122.02 |
Excellus BCBS Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $870.96 | Professional | None | $416.87 | $537.03 | $870.96 |
MVP Health Care Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $4,786.30 | Facility | None | $630.96 | $630.96 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $870.96 Median $1,737.80 Typical High $1,737.80 | Professional | None | $870.96 | $1,737.80 | $1,737.80 |
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 $457.09 Median $794.33 Typical High $1,621.81 | Professional | None | $457.09 | $794.33 | $1,621.81 |
Univera Setting Facility Modifier None Typical Low $446.68 Median $562.34 Typical High $2,818.38 | Facility | None | $446.68 | $562.34 | $2,818.38 |
Univera Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $812.83 | Professional | None | $416.87 | $537.03 | $812.83 |
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 $269.15 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $269.15 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $107.15 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $407.38 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $81.28 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $53.70 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $380.19 | $512.86 | $512.86 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $446.68 Typical High $776.25 | Professional | 54 · Surgery only | $354.81 | $446.68 | $776.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $75.86 Typical High $125.89 | Professional | 55 · Aftercare only | $58.88 | $75.86 | $125.89 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $64.57 Typical High $109.65 | Professional | 56 · Pre-op care only | $50.12 | $64.57 | $109.65 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $398.11 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $309.03 | $398.11 | $676.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $416.87 Typical High $630.96 | Professional | 53 · Discontinued | $316.23 | $416.87 | $630.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $467.74 Typical High $758.58 | Professional | 54 · Surgery only | $354.81 | $467.74 | $758.58 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $75.86 Typical High $169.82 | Professional | 55 · Aftercare only | $58.88 | $75.86 | $169.82 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $64.57 Typical High $144.54 | Professional | 56 · Pre-op care only | $50.12 | $64.57 | $144.54 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $398.11 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $309.03 | $398.11 | $645.65 |
Where New York sits
The same service costs 6.2 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· 48th of 51
$617
AK $2,512UT $407
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.