How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,445 to $11,749Professionalmedian $1,202 · 10th to 90th $977 to $2,291
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 $5,754.40 Typical High $11,481.54 | Facility | None | $1,819.70 | $5,754.40 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,513.56 | $1,584.89 | $1,584.89 |
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 $977.24 Median $1,148.15 Typical High $1,778.28 | Professional | None | $977.24 | $1,148.15 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $724.44 Typical High $1,122.02 | Professional | 62 · Two surgeons | $616.60 | $724.44 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $186.21 Typical High $281.84 | Professional | 80 · Assistant surgeon | $158.49 | $186.21 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $162.18 Typical High $245.47 | Professional | AS · PA/NP assist | $138.04 | $162.18 | $245.47 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $6,760.83 Typical High $13,489.63 | Facility | None | $1,778.28 | $6,760.83 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,202.26 Typical High $3,162.28 | Professional | None | $1,174.90 | $1,202.26 | $3,162.28 |
Emblem Health Setting Facility Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $4,677.35 | Facility | None | $1,380.38 | $1,862.09 | $4,677.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,412.54 | $2,238.72 |
Excellus BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,698.24 | Professional | None | $954.99 | $1,122.02 | $1,698.24 |
MVP Health Care Setting Facility Modifier None Typical Low $1,318.26 Median $5,754.40 Typical High $36,307.81 | Facility | None | $1,318.26 | $5,754.40 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $1,380.38 Median $1,698.24 Typical High $3,388.44 | Professional | None | $1,380.38 | $1,698.24 | $3,388.44 |
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 $794.33 Median $1,548.82 Typical High $3,630.78 | Professional | None | $794.33 | $1,548.82 | $3,630.78 |
Univera Setting Facility Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $4,786.30 | Facility | None | $1,174.90 | $1,230.27 | $4,786.30 |
Univera Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,698.24 | Professional | None | $954.99 | $1,122.02 | $1,698.24 |
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 $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $758.58 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $302.00 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,122.02 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $223.87 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $151.36 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,096.48 | $1,096.48 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $977.24 Typical High $1,479.11 | Professional | 54 · Surgery only | $831.76 | $977.24 | $1,479.11 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $218.78 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $218.78 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $123.03 Typical High $186.21 | Professional | 56 · Pre-op care only | $104.71 | $123.03 | $186.21 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $851.14 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $724.44 | $851.14 | $1,288.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $691.83 Median $741.31 Typical High $1,122.02 | Professional | 53 · Discontinued | $691.83 | $741.31 | $1,122.02 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $977.24 Typical High $1,479.11 | Professional | 54 · Surgery only | $831.76 | $977.24 | $1,479.11 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $436.52 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $436.52 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $123.03 Typical High $363.08 | Professional | 56 · Pre-op care only | $104.71 | $123.03 | $363.08 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $851.14 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $724.44 | $851.14 | $1,288.25 |
Where New York sits
The same service costs 11.0 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
$1,230
AK $5,370TX $490
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.