How much rates vary
Facilitymedian $4,677 · 10th to 90th $933 to $11,482Professionalmedian $776 · 10th to 90th $603 to $1,622
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 $1,862.09 Median $6,165.95 Typical High $11,748.98 | Facility | None | $1,862.09 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $2,398.83 | Professional | None | $691.83 | $1,096.48 | $2,398.83 |
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 $616.60 Median $724.44 Typical High $1,479.11 | Professional | None | $616.60 | $724.44 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $457.09 Typical High $933.25 | Professional | 62 · Two surgeons | $389.05 | $457.09 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $117.49 Typical High $239.88 | Professional | 80 · Assistant surgeon | $100.00 | $117.49 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $102.33 Typical High $208.93 | Professional | AS · PA/NP assist | $87.10 | $102.33 | $208.93 |
CDPHP Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $776.25 Median $870.96 Typical High $2,951.21 | Professional | None | $776.25 | $870.96 | $2,951.21 |
Emblem Health Setting Facility Modifier None Typical Low $741.31 Median $891.25 Typical High $2,884.03 | Facility | None | $741.31 | $891.25 | $2,884.03 |
Emblem Health Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,445.44 | Professional | None | $776.25 | $870.96 | $1,445.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $1,047.13 | Professional | None | $537.03 | $691.83 | $1,047.13 |
MVP Health Care Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $4,786.30 | Facility | None | $812.83 | $812.83 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,949.84 | Professional | None | $954.99 | $954.99 | $1,949.84 |
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 $588.84 Median $1,023.29 Typical High $2,089.30 | Professional | None | $588.84 | $1,023.29 | $2,089.30 |
Univera Setting Facility Modifier None Typical Low $575.44 Median $741.31 Typical High $2,570.40 | Facility | None | $575.44 | $741.31 | $2,570.40 |
Univera Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $1,023.29 | Professional | None | $537.03 | $691.83 | $1,023.29 |
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 $346.74 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $346.74 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $138.04 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $524.81 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $104.71 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $69.18 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $489.78 | $758.58 | $758.58 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $602.56 Typical High $1,023.29 | Professional | 54 · Surgery only | $457.09 | $602.56 | $1,023.29 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $97.72 Typical High $165.96 | Professional | 55 · Aftercare only | $75.86 | $97.72 | $165.96 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $83.18 Typical High $141.25 | Professional | 56 · Pre-op care only | $64.57 | $83.18 | $141.25 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $512.86 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $398.11 | $512.86 | $870.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $537.03 Typical High $812.83 | Professional | 53 · Discontinued | $407.38 | $537.03 | $812.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $602.56 Typical High $891.25 | Professional | 54 · Surgery only | $457.09 | $602.56 | $891.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $97.72 Typical High $218.78 | Professional | 55 · Aftercare only | $75.86 | $97.72 | $218.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $83.18 Typical High $186.21 | Professional | 56 · Pre-op care only | $64.57 | $83.18 | $186.21 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $512.86 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $398.11 | $512.86 | $776.25 |
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· 44th of 51
$794
AK $3,236UT $525
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.