How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,202 to $14,454Professionalmedian $2,138 · 10th to 90th $1,738 to $4,786
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 $2,398.83 Median $2,754.23 Typical High $5,011.87 | Professional | None | $2,398.83 | $2,754.23 | $5,011.87 |
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 $1,778.28 Median $2,089.30 Typical High $4,265.80 | Professional | None | $1,778.28 | $2,089.30 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,318.26 Typical High $2,630.27 | Professional | 62 · Two surgeons | $1,122.02 | $1,318.26 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $331.13 Typical High $676.08 | Professional | 80 · Assistant surgeon | $281.84 | $331.13 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $295.12 Typical High $588.84 | Professional | AS · PA/NP assist | $251.19 | $295.12 | $588.84 |
CDPHP Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,630.78 | Facility | None | $851.14 | $1,778.28 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $11,748.98 | Professional | None | $2,041.74 | $2,398.83 | $11,748.98 |
Emblem Health Setting Facility Modifier None Typical Low $2,290.87 Median $4,265.80 Typical High $8,709.64 | Facility | None | $2,290.87 | $4,265.80 | $8,709.64 |
Emblem Health Setting Professional Modifier None Typical Low $2,511.89 Median $2,754.23 Typical High $4,570.88 | Professional | None | $2,511.89 | $2,754.23 | $4,570.88 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,621.81 | $1,949.84 | $2,754.23 |
MVP Health Care Setting Facility Modifier None Typical Low $2,137.96 Median $4,786.30 Typical High $87,096.36 | Facility | None | $2,137.96 | $4,786.30 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $5,754.40 | Professional | None | $2,691.53 | $2,691.53 | $5,754.40 |
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 $1,819.70 Median $2,884.03 Typical High $6,918.31 | Professional | None | $1,819.70 | $2,884.03 | $6,918.31 |
Univera Setting Facility Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $8,128.31 | Facility | None | $1,905.46 | $2,041.74 | $8,128.31 |
Univera Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,621.81 | $1,949.84 | $2,691.53 |
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 $1,202.26 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,202.26 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $478.63 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,819.70 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $363.08 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $239.88 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,905.46 | $1,905.46 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,659.59 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,412.54 | $1,659.59 | $2,511.89 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $251.19 Typical High $371.54 | Professional | 55 · Aftercare only | $208.93 | $251.19 | $371.54 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $213.80 Typical High $316.23 | Professional | 56 · Pre-op care only | $177.83 | $213.80 | $316.23 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,479.11 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,479.11 | $2,187.76 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,071.52 Median $1,479.11 Typical High $2,137.96 | Professional | 53 · Discontinued | $1,071.52 | $1,479.11 | $2,137.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,659.59 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,412.54 | $1,659.59 | $2,344.23 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $251.19 Typical High $537.03 | Professional | 55 · Aftercare only | $208.93 | $251.19 | $537.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $213.80 Typical High $457.09 | Professional | 56 · Pre-op care only | $177.83 | $213.80 | $457.09 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,479.11 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,479.11 | $2,041.74 |
Where New York sits
The same service costs 12.0 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
$2,188
AK $8,913TX $741
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.