How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,514 to $11,749Professionalmedian $1,585 · 10th to 90th $1,288 to $2,630
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 $1,905.46 Median $6,025.60 Typical High $10,964.78 | Facility | None | $1,905.46 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,698.24 | $1,698.24 | $1,737.80 |
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 $1,348.96 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,348.96 | $1,584.89 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $245.47 Typical High $389.05 | Professional | 80 · Assistant surgeon | $218.78 | $245.47 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $223.87 Typical High $316.23 | Professional | AS · PA/NP assist | $190.55 | $223.87 | $316.23 |
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 $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 $1,737.80 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,737.80 | $6,309.57 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $3,630.78 | Professional | None | $1,584.89 | $1,584.89 | $3,630.78 |
Emblem Health Setting Facility Modifier None Typical Low $1,659.59 Median $2,290.87 Typical High $5,495.41 | Facility | None | $1,659.59 | $2,290.87 | $5,495.41 |
Emblem Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,659.59 | $1,659.59 | $2,754.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $2,137.96 | Professional | None | $933.25 | $1,348.96 | $2,137.96 |
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 $1,698.24 Median $2,137.96 Typical High $4,073.80 | Professional | None | $1,698.24 | $2,137.96 | $4,073.80 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $3,890.45 | Professional | None | $1,000.00 | $1,621.81 | $3,890.45 |
Univera Setting Facility Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $7,079.46 | Facility | None | $1,096.48 | $1,230.27 | $7,079.46 |
Univera Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,348.96 | $2,137.96 |
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 $851.14 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $851.14 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $169.82 Typical High $173.78 | Professional | 56 · Pre-op care only | $169.82 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,202.26 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,071.52 Typical High $1,698.24 | Professional | 54 · Surgery only | $724.44 | $1,071.52 | $1,698.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $281.84 Typical High $446.68 | Professional | 55 · Aftercare only | $194.98 | $281.84 | $446.68 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $134.90 Typical High $213.80 | Professional | 56 · Pre-op care only | $93.33 | $134.90 | $213.80 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $933.25 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $645.65 | $933.25 | $1,479.11 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $870.96 Typical High $1,230.27 | Professional | 53 · Discontinued | $851.14 | $870.96 | $1,230.27 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $1,071.52 Typical High $1,698.24 | Professional | 54 · Surgery only | $724.44 | $1,071.52 | $1,698.24 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $281.84 Typical High $891.25 | Professional | 55 · Aftercare only | $194.98 | $281.84 | $891.25 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $134.90 Typical High $426.58 | Professional | 56 · Pre-op care only | $93.33 | $134.90 | $426.58 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $933.25 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $645.65 | $933.25 | $1,479.11 |
Where New York sits
The same service costs 20.4 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· 46th of 51
$1,585
AK $6,607TX $324
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.