How much rates vary
Facilitymedian $2,951 · 10th to 90th $447 to $7,079Professionalmedian $316 · 10th to 90th $245 to $589
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 $338.84 Median $3,162.28 Typical High $7,762.47 | Facility | None | $338.84 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $426.58 | Professional | None | $269.15 | $354.81 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $467.74 | Professional | None | $263.03 | $309.03 | $467.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $48.98 Typical High $72.44 | Professional | 80 · Assistant surgeon | $41.69 | $48.98 | $72.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $37.15 Median $43.65 Typical High $64.57 | Professional | AS · PA/NP assist | $37.15 | $43.65 | $64.57 |
CDPHP Setting Facility Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $16,595.87 | Facility | None | $5,495.41 | $5,495.41 | $16,595.87 |
CDPHP Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $524.81 | Professional | None | $363.08 | $363.08 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $489.78 Typical High $1,000.00 | Facility | None | $100.00 | $489.78 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $812.83 | Professional | None | $251.19 | $363.08 | $812.83 |
Emblem Health Setting Facility Modifier None Typical Low $154.88 Median $288.40 Typical High $977.24 | Facility | None | $154.88 | $288.40 | $977.24 |
Emblem Health Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $707.95 | Professional | None | $346.74 | $467.74 | $707.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $208.93 Median $363.08 Typical High $489.78 | Professional | None | $208.93 | $363.08 | $489.78 |
Highmark BCBS Setting Facility Modifier None Typical Low $478.63 Median $1,659.59 Typical High $5,370.32 | Facility | None | $478.63 | $1,659.59 | $5,370.32 |
MVP Health Care Setting Facility Modifier None Typical Low $269.15 Median $3,235.94 Typical High $4,365.16 | Facility | None | $269.15 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $758.58 | Professional | None | $371.54 | $436.52 | $758.58 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,862.09 Typical High $4,897.79 | Facility | None | $537.03 | $1,862.09 | $4,897.79 |
United Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $676.08 | Professional | None | $213.80 | $331.13 | $676.08 |
Univera Setting Facility Modifier None Typical Low $177.83 Median $346.74 Typical High $707.95 | Facility | None | $177.83 | $346.74 | $707.95 |
Univera Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $489.78 | Professional | None | $245.47 | $346.74 | $489.78 |
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 $131.83 Median $173.78 Typical High $190.55 | Professional | 52 · Reduced service | $131.83 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $53.70 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $263.03 Typical High $295.12 | Professional | 54 · Surgery only | $199.53 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $39.81 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $26.92 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $245.47 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $186.21 | $245.47 | $269.15 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $288.40 Typical High $416.87 | Professional | 54 · Surgery only | $165.96 | $288.40 | $416.87 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $77.62 Typical High $109.65 | Professional | 55 · Aftercare only | $44.67 | $77.62 | $109.65 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $36.31 Typical High $52.48 | Professional | 56 · Pre-op care only | $20.89 | $36.31 | $52.48 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $251.19 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $144.54 | $251.19 | $363.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $190.55 Typical High $275.42 | Professional | 53 · Discontinued | $186.21 | $190.55 | $275.42 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $295.12 Typical High $389.05 | Professional | 54 · Surgery only | $165.96 | $295.12 | $389.05 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $79.43 Typical High $190.55 | Professional | 55 · Aftercare only | $44.67 | $79.43 | $190.55 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $38.02 Typical High $89.13 | Professional | 56 · Pre-op care only | $20.89 | $38.02 | $89.13 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $257.04 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $144.54 | $257.04 | $346.74 |
Where New York sits
The same service costs 4.5 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· 42nd of 51
$324
AK $1,072TX $240
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.