How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,549 to $11,749Professionalmedian $2,089 · 10th to 90th $1,698 to $3,467
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 $2,187.76 Median $6,025.60 Typical High $10,964.78 | Facility | None | $2,187.76 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,398.83 | Professional | None | $2,187.76 | $2,187.76 | $2,398.83 |
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 $1,778.28 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,778.28 | $2,089.30 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $331.13 Typical High $457.09 | Professional | 80 · Assistant surgeon | $281.84 | $331.13 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $295.12 Typical High $398.11 | Professional | AS · PA/NP assist | $251.19 | $295.12 | $398.11 |
CDPHP Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
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 $2,041.74 Median $2,041.74 Typical High $4,786.30 | Professional | None | $2,041.74 | $2,041.74 | $4,786.30 |
Emblem Health Setting Facility Modifier None Typical Low $2,187.76 Median $3,388.44 Typical High $7,244.36 | Facility | None | $2,187.76 | $3,388.44 | $7,244.36 |
Emblem Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,187.76 Typical High $3,548.13 | Professional | None | $1,949.84 | $2,187.76 | $3,548.13 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,778.28 | $2,818.38 |
MVP Health Care Setting Facility Modifier None Typical Low $2,511.89 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,511.89 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,238.72 Median $3,090.30 Typical High $5,370.32 | Professional | None | $2,238.72 | $3,090.30 | $5,370.32 |
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 $1,288.25 Median $2,137.96 Typical High $5,128.61 | Professional | None | $1,288.25 | $2,137.96 | $5,128.61 |
Univera Setting Facility Modifier None Typical Low $1,445.44 Median $1,949.84 Typical High $10,232.93 | Facility | None | $1,445.44 | $1,949.84 | $10,232.93 |
Univera Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,445.44 | $1,778.28 | $2,818.38 |
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 $1,096.48 Median $1,096.48 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $478.63 | Professional | 53 · Discontinued | $436.52 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $363.08 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $239.88 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,513.56 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,513.56 | $1,698.24 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,412.54 Typical High $2,238.72 | Professional | 54 · Surgery only | $954.99 | $1,412.54 | $2,238.72 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $371.54 Typical High $588.84 | Professional | 55 · Aftercare only | $257.04 | $371.54 | $588.84 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $177.83 Typical High $281.84 | Professional | 56 · Pre-op care only | $123.03 | $177.83 | $281.84 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,230.27 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $831.76 | $1,230.27 | $1,949.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,122.02 Median $1,148.15 Typical High $1,621.81 | Professional | 53 · Discontinued | $1,122.02 | $1,148.15 | $1,621.81 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,412.54 Typical High $2,238.72 | Professional | 54 · Surgery only | $954.99 | $1,412.54 | $2,238.72 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $380.19 Typical High $1,148.15 | Professional | 55 · Aftercare only | $257.04 | $380.19 | $1,148.15 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $177.83 Typical High $537.03 | Professional | 56 · Pre-op care only | $123.03 | $177.83 | $537.03 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,230.27 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $831.76 | $1,230.27 | $1,949.84 |
Where New York sits
The same service costs 21.9 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· 45th of 51
$2,089
AK $8,710TX $398
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.