How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,318 to $11,482Professionalmedian $1,047 · 10th to 90th $832 to $1,862
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 $11,481.54 | Facility | None | $1,819.70 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,258.93 | $1,318.26 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,445.44 | Professional | None | $891.25 | $1,047.13 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $912.01 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $165.96 Typical High $229.09 | Professional | 80 · Assistant surgeon | $141.25 | $165.96 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $144.54 Typical High $204.17 | Professional | AS · PA/NP assist | $123.03 | $144.54 | $204.17 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $9,120.11 | Facility | None | $1,513.56 | $4,466.84 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,511.89 | Professional | None | $933.25 | $933.25 | $2,511.89 |
Emblem Health Setting Facility Modifier None Typical Low $870.96 Median $1,174.90 Typical High $3,715.35 | Facility | None | $870.96 | $1,174.90 | $3,715.35 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $1,122.02 Typical High $1,778.28 | Professional | None | $977.24 | $1,122.02 | $1,778.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,380.38 | Professional | None | $776.25 | $912.01 | $1,380.38 |
MVP Health Care Setting Facility Modifier None Typical Low $1,202.26 Median $5,754.40 Typical High $36,307.81 | Facility | None | $1,202.26 | $5,754.40 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,412.54 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,318.26 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,202.26 Typical High $2,951.21 | Professional | None | $645.65 | $1,202.26 | $2,951.21 |
Univera Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $5,623.41 | Facility | None | $977.24 | $977.24 | $5,623.41 |
Univera Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,380.38 | Professional | None | $776.25 | $977.24 | $1,380.38 |
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 $616.60 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $616.60 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $251.19 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $933.25 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $186.21 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $870.96 | $933.25 | $933.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $794.33 Typical High $1,202.26 | Professional | 54 · Surgery only | $676.08 | $794.33 | $1,202.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $177.83 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $177.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $100.00 Typical High $151.36 | Professional | 56 · Pre-op care only | $85.11 | $100.00 | $151.36 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $691.83 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $588.84 | $691.83 | $1,047.13 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $602.56 Typical High $912.01 | Professional | 53 · Discontinued | $562.34 | $602.56 | $912.01 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $794.33 Typical High $1,202.26 | Professional | 54 · Surgery only | $676.08 | $794.33 | $1,202.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $120.23 Typical High $354.81 | Professional | 55 · Aftercare only | $100.00 | $120.23 | $354.81 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $100.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $85.11 | $100.00 | $302.00 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $691.83 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $588.84 | $691.83 | $1,047.13 |
Where New York sits
The same service costs 6.3 times more in Alaska than in Utah. 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
$1,072
AK $4,365UT $692
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.