How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,122 to $12,303Professionalmedian $1,230 · 10th to 90th $955 to $2,512
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 $2,290.87 Median $6,760.83 Typical High $12,882.50 | Facility | None | $2,290.87 | $6,760.83 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $3,467.37 | Professional | None | $1,071.52 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $6,760.83 Typical High $13,182.57 | Facility | None | $1,819.70 | $6,760.83 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $2,290.87 | Professional | None | $977.24 | $1,148.15 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $724.44 Typical High $1,445.44 | Professional | 62 · Two surgeons | $616.60 | $724.44 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $186.21 Typical High $363.08 | Professional | 80 · Assistant surgeon | $158.49 | $186.21 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $162.18 Typical High $323.59 | Professional | AS · PA/NP assist | $138.04 | $162.18 | $323.59 |
CDPHP Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $1,202.26 Median $1,318.26 Typical High $4,677.35 | Professional | None | $1,202.26 | $1,318.26 | $4,677.35 |
Emblem Health Setting Facility Modifier None Typical Low $1,174.90 Median $2,041.74 Typical High $4,265.80 | Facility | None | $1,174.90 | $2,041.74 | $4,265.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,380.38 | $2,238.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,737.80 | Professional | None | $831.76 | $1,096.48 | $1,737.80 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $4,786.30 | Facility | None | $1,288.25 | $1,288.25 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,778.28 Median $1,862.09 Typical High $3,162.28 | Professional | None | $1,778.28 | $1,862.09 | $3,162.28 |
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 $912.01 Median $1,621.81 Typical High $3,311.31 | Professional | None | $912.01 | $1,621.81 | $3,311.31 |
Univera Setting Facility Modifier None Typical Low $891.25 Median $1,122.02 Typical High $4,466.84 | Facility | None | $891.25 | $1,122.02 | $4,466.84 |
Univera Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,621.81 | Professional | None | $831.76 | $1,096.48 | $1,621.81 |
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 $537.03 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $537.03 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $213.80 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $812.83 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $162.18 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $107.15 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $758.58 | $1,071.52 | $1,071.52 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $891.25 Typical High $1,548.82 | Professional | 54 · Surgery only | $707.95 | $891.25 | $1,548.82 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $144.54 Typical High $251.19 | Professional | 55 · Aftercare only | $117.49 | $144.54 | $251.19 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $125.89 Typical High $218.78 | Professional | 56 · Pre-op care only | $100.00 | $125.89 | $218.78 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $776.25 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $616.60 | $776.25 | $1,348.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $851.14 Typical High $1,258.93 | Professional | 53 · Discontinued | $645.65 | $851.14 | $1,258.93 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $933.25 Typical High $1,513.56 | Professional | 54 · Surgery only | $707.95 | $933.25 | $1,513.56 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $151.36 Typical High $338.84 | Professional | 55 · Aftercare only | $117.49 | $151.36 | $338.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $128.82 Typical High $288.40 | Professional | 56 · Pre-op care only | $100.00 | $128.82 | $288.40 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $794.33 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $616.60 | $794.33 | $1,288.25 |
Where New York sits
The same service costs 7.1 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· 41st of 51
$1,259
AK $5,012TX $708
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.