How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,175 to $11,220Professionalmedian $1,549 · 10th to 90th $1,230 to $3,236
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 $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,630.27 | Professional | None | $1,548.82 | $1,548.82 | $2,630.27 |
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 $1,318.26 Median $1,548.82 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,548.82 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $977.24 Typical High $1,862.09 | Professional | 62 · Two surgeons | $831.76 | $977.24 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $251.19 Typical High $478.63 | Professional | 80 · Assistant surgeon | $213.80 | $251.19 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $218.78 Typical High $416.87 | Professional | AS · PA/NP assist | $186.21 | $218.78 | $416.87 |
CDPHP Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
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 $1,230.27 Median $1,698.24 Typical High $6,165.95 | Professional | None | $1,230.27 | $1,698.24 | $6,165.95 |
Emblem Health Setting Facility Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $5,623.41 | Facility | None | $1,548.82 | $1,905.46 | $5,623.41 |
Emblem Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,621.81 | $1,778.28 | $2,884.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,380.38 | $2,041.74 |
MVP Health Care Setting Facility Modifier None Typical Low $1,737.80 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,737.80 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $4,073.80 | Professional | None | $1,949.84 | $1,949.84 | $4,073.80 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,659.59 Typical High $4,570.88 | Professional | None | $912.01 | $1,659.59 | $4,570.88 |
Univera Setting Facility Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $5,248.07 | Facility | None | $1,258.93 | $1,479.11 | $5,248.07 |
Univera Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,380.38 | $1,905.46 |
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 $776.25 Median $776.25 Typical High $977.24 | Professional | 52 · Reduced service | $776.25 | $776.25 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $398.11 | Professional | 53 · Discontinued | $309.03 | $309.03 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $295.12 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $194.98 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,380.38 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,174.90 Typical High $1,862.09 | Professional | 54 · Surgery only | $933.25 | $1,174.90 | $1,862.09 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $190.55 Typical High $302.00 | Professional | 55 · Aftercare only | $154.88 | $190.55 | $302.00 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $95.50 Typical High $151.36 | Professional | 56 · Pre-op care only | $75.86 | $95.50 | $151.36 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,071.52 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $870.96 | $1,071.52 | $1,698.24 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $1,096.48 Typical High $1,659.59 | Professional | 53 · Discontinued | $831.76 | $1,096.48 | $1,659.59 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,174.90 Typical High $1,737.80 | Professional | 54 · Surgery only | $933.25 | $1,174.90 | $1,737.80 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $190.55 Typical High $446.68 | Professional | 55 · Aftercare only | $154.88 | $190.55 | $446.68 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $95.50 Typical High $223.87 | Professional | 56 · Pre-op care only | $75.86 | $95.50 | $223.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,096.48 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $870.96 | $1,096.48 | $1,621.81 |
Where New York sits
The same service costs 7.8 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· 44th of 51
$1,585
AK $6,607TX $851
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.