How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,202 to $14,454Professionalmedian $2,630 · 10th to 90th $2,089 to $5,888
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 $2,951.21 Median $3,388.44 Typical High $6,025.60 | Professional | None | $2,951.21 | $3,388.44 | $6,025.60 |
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 $2,187.76 Median $2,570.40 Typical High $5,128.61 | Professional | None | $2,187.76 | $2,570.40 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,621.81 Typical High $3,235.94 | Professional | 62 · Two surgeons | $1,380.38 | $1,621.81 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $416.87 Typical High $831.76 | Professional | 80 · Assistant surgeon | $354.81 | $416.87 | $831.76 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $363.08 Typical High $724.44 | Professional | AS · PA/NP assist | $309.03 | $363.08 | $724.44 |
CDPHP Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $4,466.84 | Facility | None | $851.14 | $1,778.28 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $13,489.63 | Professional | None | $2,511.89 | $3,019.95 | $13,489.63 |
Emblem Health Setting Facility Modifier None Typical Low $2,754.23 Median $4,073.80 Typical High $10,232.93 | Facility | None | $2,754.23 | $4,073.80 | $10,232.93 |
Emblem Health Setting Professional Modifier None Typical Low $2,951.21 Median $3,388.44 Typical High $5,623.41 | Professional | None | $2,951.21 | $3,388.44 | $5,623.41 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $3,388.44 | Professional | None | $1,995.26 | $2,344.23 | $3,388.44 |
MVP Health Care Setting Facility Modifier None Typical Low $2,511.89 Median $4,786.30 Typical High $87,096.36 | Facility | None | $2,511.89 | $4,786.30 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $7,079.46 | Professional | None | $2,691.53 | $2,691.53 | $7,079.46 |
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 $2,238.72 Median $3,467.37 Typical High $8,511.38 | Professional | None | $2,238.72 | $3,467.37 | $8,511.38 |
Univera Setting Facility Modifier None Typical Low $2,344.23 Median $2,570.40 Typical High $8,912.51 | Facility | None | $2,344.23 | $2,570.40 | $8,912.51 |
Univera Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $3,311.31 | Professional | None | $1,995.26 | $2,344.23 | $3,311.31 |
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 $1,479.11 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,479.11 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $588.84 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,238.72 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $446.68 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $295.12 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,398.83 | $2,398.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,041.74 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,737.80 | $2,041.74 | $3,090.30 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $302.00 Typical High $457.09 | Professional | 55 · Aftercare only | $257.04 | $302.00 | $457.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $257.04 Typical High $389.05 | Professional | 56 · Pre-op care only | $218.78 | $257.04 | $389.05 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,778.28 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,778.28 | $2,691.53 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,318.26 Median $1,819.70 Typical High $2,630.27 | Professional | 53 · Discontinued | $1,318.26 | $1,819.70 | $2,630.27 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $2,041.74 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,737.80 | $2,041.74 | $2,884.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $302.00 Typical High $660.69 | Professional | 55 · Aftercare only | $257.04 | $302.00 | $660.69 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $257.04 Typical High $562.34 | Professional | 56 · Pre-op care only | $218.78 | $257.04 | $562.34 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,778.28 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,778.28 | $2,570.40 |
Where New York sits
The same service costs 17.0 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· 39th of 51
$2,692
AK $10,965TX $646
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.