How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,479 to $14,125Professionalmedian $1,288 · 10th to 90th $1,023 to $2,630
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 $1,698.24 Median $6,165.95 Typical High $12,022.64 | Facility | None | $1,698.24 | $6,165.95 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,621.81 Typical High $3,981.07 | Professional | None | $1,148.15 | $1,621.81 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,230.27 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $776.25 Typical High $1,513.56 | Professional | 62 · Two surgeons | $660.69 | $776.25 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $194.98 Typical High $389.05 | Professional | 80 · Assistant surgeon | $165.96 | $194.98 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $169.82 Typical High $338.84 | Professional | AS · PA/NP assist | $144.54 | $169.82 | $338.84 |
CDPHP Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $12,302.69 | Facility | None | $4,073.80 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $5,248.07 Typical High $10,471.29 | Facility | None | $1,737.80 | $5,248.07 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $4,897.79 | Professional | None | $1,258.93 | $1,348.96 | $4,897.79 |
Emblem Health Setting Facility Modifier None Typical Low $1,348.96 Median $2,344.23 Typical High $4,786.30 | Facility | None | $1,348.96 | $2,344.23 | $4,786.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,258.93 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,445.44 | $2,344.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,862.09 | Professional | None | $870.96 | $1,174.90 | $1,862.09 |
MVP Health Care Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $4,786.30 | Facility | None | $1,380.38 | $1,380.38 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,995.26 Median $2,089.30 Typical High $3,311.31 | Professional | None | $1,995.26 | $2,089.30 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,302.69 | Facility | None | $1,318.26 | $3,548.13 | $12,302.69 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,659.59 Typical High $3,467.37 | Professional | None | $954.99 | $1,659.59 | $3,467.37 |
Univera Setting Facility Modifier None Typical Low $954.99 Median $1,202.26 Typical High $4,570.88 | Facility | None | $954.99 | $1,202.26 | $4,570.88 |
Univera Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,698.24 | Professional | None | $870.96 | $1,174.90 | $1,698.24 |
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 $575.44 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $575.44 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $229.09 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $851.14 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $169.82 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $114.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $794.33 | $1,122.02 | $1,122.02 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $954.99 Typical High $1,659.59 | Professional | 54 · Surgery only | $758.58 | $954.99 | $1,659.59 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $154.88 Typical High $269.15 | Professional | 55 · Aftercare only | $123.03 | $154.88 | $269.15 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $131.83 Typical High $229.09 | Professional | 56 · Pre-op care only | $104.71 | $131.83 | $229.09 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $812.83 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $645.65 | $812.83 | $1,412.54 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $891.25 Typical High $1,318.26 | Professional | 53 · Discontinued | $676.08 | $891.25 | $1,318.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $977.24 Typical High $1,584.89 | Professional | 54 · Surgery only | $758.58 | $977.24 | $1,584.89 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $158.49 Typical High $354.81 | Professional | 55 · Aftercare only | $123.03 | $158.49 | $354.81 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $138.04 Typical High $309.03 | Professional | 56 · Pre-op care only | $104.71 | $138.04 | $309.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $851.14 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $645.65 | $851.14 | $1,380.38 |
Where New York sits
The same service costs 6.9 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· 45th of 51
$1,318
AK $5,370TX $776
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.