How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,349 to $12,589Professionalmedian $955 · 10th to 90th $776 to $1,820
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 $1,659.59 Median $5,248.07 Typical High $10,471.29 | Facility | None | $1,659.59 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,202.26 | $1,230.27 | $1,230.27 |
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 $776.25 Median $912.01 Typical High $1,412.54 | Professional | None | $776.25 | $912.01 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $575.44 Typical High $870.96 | Professional | 62 · Two surgeons | $489.78 | $575.44 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $147.91 Typical High $223.87 | Professional | 80 · Assistant surgeon | $125.89 | $147.91 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $128.82 Typical High $194.98 | Professional | AS · PA/NP assist | $109.65 | $128.82 | $194.98 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $10,715.19 Typical High $21,877.62 | Facility | None | $1,412.54 | $10,715.19 | $21,877.62 |
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 $1,096.48 Median $1,445.44 Typical High $3,715.35 | Facility | None | $1,096.48 | $1,445.44 | $3,715.35 |
Emblem Health Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,778.28 | Professional | None | $977.24 | $1,148.15 | $1,778.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,230.27 | Professional | None | $776.25 | $912.01 | $1,230.27 |
MVP Health Care Setting Facility Modifier None Typical Low $1,071.52 Median $5,754.40 Typical High $36,307.81 | Facility | None | $1,071.52 | $5,754.40 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $2,691.53 | Professional | None | $1,096.48 | $1,318.26 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $13,182.57 | Facility | None | $1,318.26 | $3,548.13 | $13,182.57 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,230.27 Typical High $2,884.03 | Professional | None | $630.96 | $1,230.27 | $2,884.03 |
Univera Setting Facility Modifier None Typical Low $933.25 Median $977.24 Typical High $3,801.89 | Facility | None | $933.25 | $977.24 | $3,801.89 |
Univera Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,230.27 | Professional | None | $776.25 | $912.01 | $1,230.27 |
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 $602.56 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $602.56 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $239.88 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $891.25 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $177.83 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $120.23 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $831.76 | $851.14 | $851.14 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $794.33 Typical High $1,174.90 | Professional | 54 · Surgery only | $676.08 | $794.33 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $173.78 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $173.78 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $100.00 Typical High $147.91 | Professional | 56 · Pre-op care only | $85.11 | $100.00 | $147.91 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $691.83 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $588.84 | $691.83 | $1,023.29 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $575.44 Typical High $891.25 | Professional | 53 · Discontinued | $549.54 | $575.44 | $891.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $794.33 Typical High $1,071.52 | Professional | 54 · Surgery only | $676.08 | $794.33 | $1,071.52 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $117.49 Typical High $354.81 | Professional | 55 · Aftercare only | $100.00 | $117.49 | $354.81 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $100.00 Typical High $295.12 | Professional | 56 · Pre-op care only | $85.11 | $100.00 | $295.12 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $691.83 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $588.84 | $691.83 | $977.24 |
Where New York sits
The same service costs 6.2 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· 47th of 51
$977
AK $4,266UT $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.