How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,202 to $14,454Professionalmedian $2,344 · 10th to 90th $1,820 to $4,266
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 $2,630.27 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,630.27 | $2,951.21 | $2,951.21 |
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 $1,949.84 Median $2,290.87 Typical High $3,388.44 | Professional | None | $1,949.84 | $2,290.87 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,445.44 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,230.27 | $1,445.44 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $363.08 Typical High $537.03 | Professional | 80 · Assistant surgeon | $309.03 | $363.08 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $316.23 Typical High $478.63 | Professional | AS · PA/NP assist | $269.15 | $316.23 | $478.63 |
CDPHP Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,981.07 | Facility | None | $851.14 | $1,778.28 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $2,344.23 Typical High $5,754.40 | Professional | None | $2,238.72 | $2,344.23 | $5,754.40 |
Emblem Health Setting Facility Modifier None Typical Low $2,511.89 Median $4,570.88 Typical High $9,332.54 | Facility | None | $2,511.89 | $4,570.88 | $9,332.54 |
Emblem Health Setting Professional Modifier None Typical Low $2,238.72 Median $2,754.23 Typical High $4,365.16 | Professional | None | $2,238.72 | $2,754.23 | $4,365.16 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,778.28 | $2,089.30 | $2,818.38 |
MVP Health Care Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $38,018.94 | Facility | None | $2,290.87 | $5,754.40 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $2,454.71 Median $2,754.23 Typical High $6,309.57 | Professional | None | $2,454.71 | $2,754.23 | $6,309.57 |
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 $1,513.56 Median $2,818.38 Typical High $6,760.83 | Professional | None | $1,513.56 | $2,818.38 | $6,760.83 |
Univera Setting Facility Modifier None Typical Low $2,089.30 Median $2,238.72 Typical High $8,511.38 | Facility | None | $2,089.30 | $2,238.72 | $8,511.38 |
Univera Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,691.53 | Professional | None | $1,778.28 | $2,089.30 | $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 $1,318.26 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,318.26 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $524.81 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,995.26 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $398.11 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $263.03 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,041.74 | $2,041.74 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,819.70 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,548.82 | $1,819.70 | $2,570.40 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $275.42 Typical High $389.05 | Professional | 55 · Aftercare only | $229.09 | $275.42 | $389.05 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $234.42 Typical High $323.59 | Professional | 56 · Pre-op care only | $194.98 | $234.42 | $323.59 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,584.89 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,584.89 | $2,238.72 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,230.27 Median $1,230.27 Typical High $1,737.80 | Professional | 53 · Discontinued | $1,230.27 | $1,230.27 | $1,737.80 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,819.70 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,548.82 | $1,819.70 | $2,344.23 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $275.42 Typical High $776.25 | Professional | 55 · Aftercare only | $229.09 | $275.42 | $776.25 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $234.42 Typical High $660.69 | Professional | 56 · Pre-op care only | $194.98 | $234.42 | $660.69 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,584.89 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,584.89 | $2,238.72 |
Where New York sits
The same service costs 23.4 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· 41st of 51
$2,344
AK $9,550TX $407
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.