How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,202 to $14,454Professionalmedian $2,291 · 10th to 90th $1,862 to $5,129
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 $2,570.40 Median $2,951.21 Typical High $5,248.07 | Professional | None | $2,570.40 | $2,951.21 | $5,248.07 |
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 $1,905.46 Median $2,238.72 Typical High $4,570.88 | Professional | None | $1,905.46 | $2,238.72 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,412.54 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,202.26 | $1,412.54 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $354.81 Typical High $724.44 | Professional | 80 · Assistant surgeon | $302.00 | $354.81 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $316.23 Typical High $630.96 | Professional | AS · PA/NP assist | $269.15 | $316.23 | $630.96 |
CDPHP Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,890.45 | Facility | None | $851.14 | $1,778.28 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $12,589.25 | Professional | None | $2,187.76 | $2,754.23 | $12,589.25 |
Emblem Health Setting Facility Modifier None Typical Low $2,511.89 Median $3,548.13 Typical High $9,120.11 | Facility | None | $2,511.89 | $3,548.13 | $9,120.11 |
Emblem Health Setting Professional Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $4,897.79 | Professional | None | $2,570.40 | $2,951.21 | $4,897.79 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,737.80 | $2,041.74 | $2,951.21 |
MVP Health Care Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $87,096.36 | Facility | None | $2,290.87 | $5,754.40 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $6,165.95 | Professional | None | $3,019.95 | $3,019.95 | $6,165.95 |
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 $1,949.84 Median $3,090.30 Typical High $7,413.10 | Professional | None | $1,949.84 | $3,090.30 | $7,413.10 |
Univera Setting Facility Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $10,232.93 | Facility | None | $2,041.74 | $2,238.72 | $10,232.93 |
Univera Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,884.03 | Professional | None | $1,737.80 | $2,041.74 | $2,884.03 |
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 $1,288.25 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,288.25 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $512.86 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,238.72 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,949.84 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $389.05 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $257.04 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $2,089.30 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,819.70 | $2,089.30 | $2,089.30 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,778.28 Typical High $2,691.53 | Professional | 54 · Surgery only | $1,513.56 | $1,778.28 | $2,691.53 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $269.15 Typical High $407.38 | Professional | 55 · Aftercare only | $223.87 | $269.15 | $407.38 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $229.09 Typical High $338.84 | Professional | 56 · Pre-op care only | $190.55 | $229.09 | $338.84 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,584.89 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,584.89 | $2,344.23 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,148.15 Median $1,584.89 Typical High $2,290.87 | Professional | 53 · Discontinued | $1,148.15 | $1,584.89 | $2,290.87 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,778.28 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,513.56 | $1,778.28 | $2,570.40 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $269.15 Typical High $575.44 | Professional | 55 · Aftercare only | $223.87 | $269.15 | $575.44 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $229.09 Typical High $489.78 | Professional | 56 · Pre-op care only | $190.55 | $229.09 | $489.78 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,584.89 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,584.89 | $2,238.72 |
Where New York sits
The same service costs 7.6 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· 42nd of 51
$2,344
AK $9,550TX $1,259
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.