How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,072 to $14,454Professionalmedian $1,000 · 10th to 90th $813 to $2,239
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 $1,122.02 Median $1,258.93 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,258.93 | $2,344.23 |
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 $831.76 Median $977.24 Typical High $1,995.26 | Professional | None | $831.76 | $977.24 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $616.60 Typical High $1,230.27 | Professional | 62 · Two surgeons | $524.81 | $616.60 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $154.88 Typical High $316.23 | Professional | 80 · Assistant surgeon | $131.83 | $154.88 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $134.90 Typical High $275.42 | Professional | AS · PA/NP assist | $114.82 | $134.90 | $275.42 |
CDPHP Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
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 $954.99 Median $1,202.26 Typical High $5,011.87 | Professional | None | $954.99 | $1,202.26 | $5,011.87 |
Emblem Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $4,168.69 | Facility | None | $1,122.02 | $1,737.80 | $4,168.69 |
Emblem Health Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,348.96 | $2,398.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,288.25 | Professional | None | $758.58 | $954.99 | $1,288.25 |
MVP Health Care Setting Facility Modifier None Typical Low $977.24 Median $4,786.30 Typical High $87,096.36 | Facility | None | $977.24 | $4,786.30 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,630.27 | Professional | None | $1,096.48 | $1,096.48 | $2,630.27 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,737.80 Typical High $6,165.95 | Facility | None | $575.44 | $1,737.80 | $6,165.95 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,380.38 Typical High $3,162.28 | Professional | None | $891.25 | $1,380.38 | $3,162.28 |
Univera Setting Facility Modifier None Typical Low $891.25 Median $954.99 Typical High $3,388.44 | Facility | None | $891.25 | $954.99 | $3,388.44 |
Univera Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,288.25 | Professional | None | $758.58 | $954.99 | $1,288.25 |
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 $562.34 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $562.34 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $223.87 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $851.14 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $169.82 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $112.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $794.33 | $870.96 | $870.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $831.76 Typical High $1,202.26 | Professional | 54 · Surgery only | $660.69 | $831.76 | $1,202.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $123.03 Typical High $177.83 | Professional | 55 · Aftercare only | $100.00 | $123.03 | $177.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $104.71 Typical High $151.36 | Professional | 56 · Pre-op care only | $85.11 | $104.71 | $151.36 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $724.44 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $575.44 | $724.44 | $1,047.13 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $676.08 Typical High $1,000.00 | Professional | 53 · Discontinued | $489.78 | $676.08 | $1,000.00 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $831.76 Typical High $1,122.02 | Professional | 54 · Surgery only | $660.69 | $831.76 | $1,122.02 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $123.03 Typical High $257.04 | Professional | 55 · Aftercare only | $100.00 | $123.03 | $257.04 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $104.71 Typical High $213.80 | Professional | 56 · Pre-op care only | $85.11 | $104.71 | $213.80 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $724.44 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $575.44 | $724.44 | $977.24 |
Where New York sits
The same service costs 18.6 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· 43rd of 51
$1,023
AK $4,169TX $224
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.