How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,202 to $14,125Professionalmedian $1,349 · 10th to 90th $1,072 to $3,020
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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $2,238.72 | Professional | None | $1,513.56 | $1,737.80 | $2,238.72 |
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 $1,122.02 Median $1,318.26 Typical High $2,630.27 | Professional | None | $1,122.02 | $1,318.26 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $831.76 Typical High $1,659.59 | Professional | 62 · Two surgeons | $707.95 | $831.76 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $208.93 Typical High $426.58 | Professional | 80 · Assistant surgeon | $177.83 | $208.93 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $186.21 Typical High $371.54 | Professional | AS · PA/NP assist | $158.49 | $186.21 | $371.54 |
CDPHP Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $1,288.25 Median $1,621.81 Typical High $7,413.10 | Professional | None | $1,288.25 | $1,621.81 | $7,413.10 |
Emblem Health Setting Facility Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $5,495.41 | Facility | None | $1,288.25 | $1,698.24 | $5,495.41 |
Emblem Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $2,951.21 | Professional | None | $1,548.82 | $1,778.28 | $2,951.21 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,258.93 | $1,737.80 |
MVP Health Care Setting Facility Modifier None Typical Low $1,318.26 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,318.26 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $3,630.78 | Professional | None | $1,698.24 | $1,698.24 | $3,630.78 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $4,365.16 | Professional | None | $1,174.90 | $1,819.70 | $4,365.16 |
Univera Setting Facility Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $5,495.41 | Facility | None | $1,202.26 | $1,318.26 | $5,495.41 |
Univera Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,258.93 | $1,737.80 |
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 $758.58 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $758.58 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $302.00 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,148.15 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $229.09 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $151.36 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,202.26 | $1,202.26 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,096.48 Typical High $1,621.81 | Professional | 54 · Surgery only | $891.25 | $1,096.48 | $1,621.81 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $162.18 Typical High $239.88 | Professional | 55 · Aftercare only | $134.90 | $162.18 | $239.88 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $138.04 Typical High $204.17 | Professional | 56 · Pre-op care only | $112.20 | $138.04 | $204.17 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $954.99 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $776.25 | $954.99 | $1,412.54 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $933.25 Typical High $1,348.96 | Professional | 53 · Discontinued | $676.08 | $933.25 | $1,348.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,096.48 Typical High $1,513.56 | Professional | 54 · Surgery only | $891.25 | $1,096.48 | $1,513.56 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $162.18 Typical High $346.74 | Professional | 55 · Aftercare only | $134.90 | $162.18 | $346.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $138.04 Typical High $288.40 | Professional | 56 · Pre-op care only | $112.20 | $138.04 | $288.40 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $954.99 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $776.25 | $954.99 | $1,318.26 |
Where New York sits
The same service costs 5.8 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· 46th of 51
$1,380
AK $5,623TX $977
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.