How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,259 to $14,125Professionalmedian $1,230 · 10th to 90th $977 to $2,692
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 $1,819.70 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,380.38 | $1,548.82 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $15,488.17 | Facility | None | $1,862.09 | $8,709.64 | $15,488.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $2,454.71 | Professional | None | $1,000.00 | $1,174.90 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $741.31 Typical High $1,513.56 | Professional | 62 · Two surgeons | $630.96 | $741.31 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $380.19 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $165.96 Typical High $338.84 | Professional | AS · PA/NP assist | $141.25 | $165.96 | $338.84 |
CDPHP Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
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 $1,174.90 Median $1,479.11 Typical High $6,165.95 | Professional | None | $1,174.90 | $1,479.11 | $6,165.95 |
Emblem Health Setting Facility Modifier None Typical Low $1,348.96 Median $2,454.71 Typical High $5,011.87 | Facility | None | $1,348.96 | $2,454.71 | $5,011.87 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $2,691.53 | Professional | None | $1,445.44 | $1,621.81 | $2,691.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,584.89 | Professional | None | $933.25 | $1,148.15 | $1,584.89 |
MVP Health Care Setting Facility Modifier None Typical Low $1,202.26 Median $4,786.30 Typical High $87,096.36 | Facility | None | $1,202.26 | $4,786.30 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $3,235.94 | Professional | None | $1,479.11 | $1,479.11 | $3,235.94 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,949.84 Typical High $6,309.57 | Facility | None | $758.58 | $1,949.84 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $3,890.45 | Professional | None | $1,071.52 | $1,659.59 | $3,890.45 |
Univera Setting Facility Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $3,715.35 | Facility | None | $1,096.48 | $1,174.90 | $3,715.35 |
Univera Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $1,584.89 | Professional | None | $933.25 | $1,148.15 | $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 $691.83 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $691.83 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $275.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,023.29 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $208.93 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $138.04 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $954.99 | $1,071.52 | $1,071.52 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,000.00 Typical High $1,445.44 | Professional | 54 · Surgery only | $812.83 | $1,000.00 | $1,445.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $147.91 Typical High $218.78 | Professional | 55 · Aftercare only | $120.23 | $147.91 | $218.78 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $125.89 Typical High $181.97 | Professional | 56 · Pre-op care only | $102.33 | $125.89 | $181.97 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $870.96 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $707.95 | $870.96 | $1,258.93 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $831.76 Typical High $1,230.27 | Professional | 53 · Discontinued | $602.56 | $831.76 | $1,230.27 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,000.00 Typical High $1,380.38 | Professional | 54 · Surgery only | $812.83 | $1,000.00 | $1,380.38 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $147.91 Typical High $309.03 | Professional | 55 · Aftercare only | $120.23 | $147.91 | $309.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $125.89 Typical High $263.03 | Professional | 56 · Pre-op care only | $102.33 | $125.89 | $263.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $870.96 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $707.95 | $870.96 | $1,202.26 |
Where New York sits
The same service costs 5.6 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· 44th of 51
$1,259
AK $5,012TX $891
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.