How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,230 to $11,482Professionalmedian $759 · 10th to 90th $617 to $1,230
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 $6,309.57 Typical High $13,182.57 | Facility | None | $1,819.70 | $6,309.57 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $891.25 | Professional | None | $676.08 | $676.08 | $891.25 |
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 $645.65 Median $758.58 Typical High $977.24 | Professional | None | $645.65 | $758.58 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $123.03 Typical High $147.91 | Professional | 80 · Assistant surgeon | $104.71 | $123.03 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $107.15 Typical High $128.82 | Professional | AS · PA/NP assist | $91.20 | $107.15 | $128.82 |
CDPHP Setting Facility Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $13,489.63 | Facility | None | $3,388.44 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $4,897.79 Typical High $10,232.93 | Facility | None | $1,737.80 | $4,897.79 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,621.81 | Professional | None | $724.44 | $724.44 | $1,621.81 |
Emblem Health Setting Facility Modifier None Typical Low $758.58 Median $954.99 Typical High $2,884.03 | Facility | None | $758.58 | $954.99 | $2,884.03 |
Emblem Health Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,258.93 | Professional | None | $691.83 | $831.76 | $1,258.93 |
Excellus BCBS Setting Professional Modifier None Typical Low $416.87 Median $660.69 Typical High $977.24 | Professional | None | $416.87 | $660.69 | $977.24 |
Highmark BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $9,120.11 | Facility | None | $8,912.51 | $8,912.51 | $9,120.11 |
MVP Health Care Setting Facility Modifier None Typical Low $741.31 Median $4,786.30 Typical High $5,754.40 | Facility | None | $741.31 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $1,949.84 | Professional | None | $794.33 | $794.33 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $8,709.64 | Facility | None | $1,122.02 | $2,754.23 | $8,709.64 |
United Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $1,737.80 | Professional | None | $501.19 | $776.25 | $1,737.80 |
Univera Setting Facility Modifier None Typical Low $501.19 Median $691.83 Typical High $2,884.03 | Facility | None | $501.19 | $691.83 | $2,884.03 |
Univera Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $977.24 | Professional | None | $501.19 | $660.69 | $977.24 |
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 $338.84 Median $338.84 Typical High $389.05 | Professional | 52 · Reduced service | $338.84 | $338.84 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $158.49 | Professional | 53 · Discontinued | $134.90 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $588.84 | Professional | 54 · Surgery only | $501.19 | $501.19 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $549.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $524.81 Typical High $776.25 | Professional | 54 · Surgery only | $331.13 | $524.81 | $776.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $141.25 Typical High $204.17 | Professional | 55 · Aftercare only | $89.13 | $141.25 | $204.17 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $66.07 Typical High $97.72 | Professional | 56 · Pre-op care only | $41.69 | $66.07 | $97.72 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $457.09 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $288.40 | $457.09 | $676.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $407.38 Typical High $588.84 | Professional | 53 · Discontinued | $398.11 | $407.38 | $588.84 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $524.81 Typical High $776.25 | Professional | 54 · Surgery only | $331.13 | $524.81 | $776.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $141.25 Typical High $407.38 | Professional | 55 · Aftercare only | $89.13 | $141.25 | $407.38 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $66.07 Typical High $190.55 | Professional | 56 · Pre-op care only | $41.69 | $66.07 | $190.55 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $457.09 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $288.40 | $457.09 | $691.83 |
Where New York sits
The same service costs 17.4 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· 41st of 51
$759
AK $3,020TX $174
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.