How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,122 to $11,482Professionalmedian $1,230 · 10th to 90th $977 to $2,138
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,412.54 | Professional | None | $1,348.96 | $1,348.96 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,456.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,621.81 | Professional | None | $1,047.13 | $1,230.27 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $776.25 Typical High $1,023.29 | Professional | 62 · Two surgeons | $660.69 | $776.25 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $194.98 Typical High $257.04 | Professional | 80 · Assistant surgeon | $165.96 | $194.98 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $173.78 Typical High $223.87 | Professional | AS · PA/NP assist | $144.54 | $173.78 | $223.87 |
CDPHP Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $1,096.48 Median $1,096.48 Typical High $2,754.23 | Professional | None | $1,096.48 | $1,096.48 | $2,754.23 |
Emblem Health Setting Facility Modifier None Typical Low $1,230.27 Median $2,187.76 Typical High $4,466.84 | Facility | None | $1,230.27 | $2,187.76 | $4,466.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,348.96 | $2,089.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,445.44 | Professional | None | $912.01 | $1,071.52 | $1,445.44 |
MVP Health Care Setting Facility Modifier None Typical Low $1,230.27 Median $5,754.40 Typical High $36,307.81 | Facility | None | $1,230.27 | $5,754.40 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $3,235.94 | Professional | None | $1,318.26 | $1,380.38 | $3,235.94 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,165.95 | Facility | None | $575.44 | $1,778.28 | $6,165.95 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,445.44 Typical High $3,467.37 | Professional | None | $758.58 | $1,445.44 | $3,467.37 |
Univera Setting Facility Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $4,570.88 | Facility | None | $1,122.02 | $1,148.15 | $4,570.88 |
Univera Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,445.44 | Professional | None | $912.01 | $1,071.52 | $1,445.44 |
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 $676.08 Median $676.08 Typical High $707.95 | Professional | 52 · Reduced service | $676.08 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $281.84 | Professional | 53 · Discontinued | $269.15 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $213.80 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $141.25 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,000.00 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $933.25 Typical High $1,380.38 | Professional | 54 · Surgery only | $794.33 | $933.25 | $1,380.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $138.04 Typical High $204.17 | Professional | 55 · Aftercare only | $117.49 | $138.04 | $204.17 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $117.49 Typical High $173.78 | Professional | 56 · Pre-op care only | $100.00 | $117.49 | $173.78 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $812.83 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $691.83 | $812.83 | $1,202.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $707.95 Typical High $1,071.52 | Professional | 53 · Discontinued | $660.69 | $707.95 | $1,071.52 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $933.25 Typical High $1,258.93 | Professional | 54 · Surgery only | $794.33 | $933.25 | $1,258.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $138.04 Typical High $416.87 | Professional | 55 · Aftercare only | $117.49 | $138.04 | $416.87 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $117.49 Typical High $354.81 | Professional | 56 · Pre-op care only | $100.00 | $117.49 | $354.81 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $812.83 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $691.83 | $812.83 | $1,148.15 |
Where New York sits
The same service costs 6.5 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· 40th of 51
$1,259
AK $5,012TX $776
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.