How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,660 to $14,454Professionalmedian $2,630 · 10th to 90th $2,138 to $4,677
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 $2,238.72 Median $6,165.95 Typical High $10,964.78 | Facility | None | $2,238.72 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,951.21 | Professional | None | $2,344.23 | $2,344.23 | $2,951.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $2,630.27 Typical High $3,548.13 | Professional | None | $2,238.72 | $2,630.27 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $426.58 Typical High $562.34 | Professional | 80 · Assistant surgeon | $363.08 | $426.58 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $371.54 Typical High $489.78 | Professional | AS · PA/NP assist | $316.23 | $371.54 | $489.78 |
CDPHP Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $10,964.78 | Facility | None | $3,630.78 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,621.81 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $6,025.60 | Professional | None | $2,818.38 | $2,818.38 | $6,025.60 |
Emblem Health Setting Facility Modifier None Typical Low $2,570.40 Median $3,090.30 Typical High $9,772.37 | Facility | None | $2,570.40 | $3,090.30 | $9,772.37 |
Emblem Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $5,011.87 | Professional | None | $3,019.95 | $3,019.95 | $5,011.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $2,398.83 Typical High $4,786.30 | Professional | None | $1,348.96 | $2,398.83 | $4,786.30 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,786.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $7,244.36 | Professional | None | $2,951.21 | $3,801.89 | $7,244.36 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,073.80 | $14,125.38 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,951.21 Typical High $6,456.54 | Professional | None | $1,819.70 | $2,951.21 | $6,456.54 |
Univera Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $8,128.31 | Facility | None | $1,584.89 | $2,089.30 | $8,128.31 |
Univera Setting Professional Modifier None Typical Low $1,584.89 Median $2,344.23 Typical High $4,786.30 | Professional | None | $1,584.89 | $2,344.23 | $4,786.30 |
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 $1,174.90 Median $1,174.90 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $588.84 | Professional | 53 · Discontinued | $467.74 | $467.74 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $436.52 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $295.12 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $2,041.74 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,905.46 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,047.13 | $1,905.46 | $3,715.35 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $501.19 Typical High $1,000.00 | Professional | 55 · Aftercare only | $281.84 | $501.19 | $1,000.00 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $239.88 Typical High $478.63 | Professional | 56 · Pre-op care only | $134.90 | $239.88 | $478.63 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,659.59 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $933.25 | $1,659.59 | $3,311.31 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,479.11 Median $1,479.11 Typical High $2,290.87 | Professional | 53 · Discontinued | $1,479.11 | $1,479.11 | $2,290.87 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,905.46 Typical High $3,715.35 | Professional | 54 · Surgery only | $1,047.13 | $1,905.46 | $3,715.35 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $501.19 Typical High $1,479.11 | Professional | 55 · Aftercare only | $281.84 | $501.19 | $1,479.11 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $239.88 Typical High $707.95 | Professional | 56 · Pre-op care only | $134.90 | $239.88 | $707.95 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,659.59 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $933.25 | $1,659.59 | $3,311.31 |
Where New York sits
The same service costs 19.5 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· 44th of 51
$2,630
AK $11,482TX $589
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.