How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,445 to $11,482Professionalmedian $1,175 · 10th to 90th $933 to $2,455
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 $1,905.46 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,905.46 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $3,715.35 | Professional | None | $1,071.52 | $1,513.56 | $3,715.35 |
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 $954.99 Median $1,122.02 Typical High $2,238.72 | Professional | None | $954.99 | $1,122.02 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $707.95 Typical High $1,412.54 | Professional | 62 · Two surgeons | $602.56 | $707.95 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $177.83 Typical High $363.08 | Professional | 80 · Assistant surgeon | $151.36 | $177.83 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $158.49 Typical High $316.23 | Professional | AS · PA/NP assist | $134.90 | $158.49 | $316.23 |
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 $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $3,890.45 Typical High $7,762.47 | Facility | None | $1,737.80 | $3,890.45 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $4,466.84 | Professional | None | $1,174.90 | $1,258.93 | $4,466.84 |
Emblem Health Setting Facility Modifier None Typical Low $1,258.93 Median $2,187.76 Typical High $4,466.84 | Facility | None | $1,258.93 | $2,187.76 | $4,466.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,318.26 | $2,187.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,737.80 | Professional | None | $812.83 | $1,071.52 | $1,737.80 |
MVP Health Care Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $4,786.30 | Facility | None | $1,258.93 | $1,258.93 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,819.70 | $2,041.74 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $11,481.54 | Facility | None | $1,318.26 | $3,548.13 | $11,481.54 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,548.82 Typical High $3,235.94 | Professional | None | $891.25 | $1,548.82 | $3,235.94 |
Univera Setting Facility Modifier None Typical Low $891.25 Median $1,122.02 Typical High $3,890.45 | Facility | None | $891.25 | $1,122.02 | $3,890.45 |
Univera Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,584.89 | Professional | None | $812.83 | $1,071.52 | $1,584.89 |
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 $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $537.03 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $213.80 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $794.33 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $158.49 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $107.15 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $741.31 | $1,047.13 | $1,047.13 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $870.96 Typical High $1,513.56 | Professional | 54 · Surgery only | $707.95 | $870.96 | $1,513.56 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $144.54 Typical High $251.19 | Professional | 55 · Aftercare only | $114.82 | $144.54 | $251.19 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $123.03 Typical High $213.80 | Professional | 56 · Pre-op care only | $97.72 | $123.03 | $213.80 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $758.58 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $602.56 | $758.58 | $1,318.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $831.76 Typical High $1,230.27 | Professional | 53 · Discontinued | $630.96 | $831.76 | $1,230.27 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $912.01 Typical High $1,479.11 | Professional | 54 · Surgery only | $707.95 | $912.01 | $1,479.11 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $147.91 Typical High $331.13 | Professional | 55 · Aftercare only | $114.82 | $147.91 | $331.13 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $128.82 Typical High $281.84 | Professional | 56 · Pre-op care only | $97.72 | $128.82 | $281.84 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $794.33 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $602.56 | $794.33 | $1,288.25 |
Where New York sits
The same service costs 7.2 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
$1,202
AK $4,898TX $676
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.