How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,230 to $11,482Professionalmedian $724 · 10th to 90th $575 to $1,202
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 $6,456.54 Typical High $13,182.57 | Facility | None | $1,819.70 | $6,456.54 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $851.14 | Professional | None | $758.58 | $758.58 | $851.14 |
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 $602.56 Median $707.95 Typical High $977.24 | Professional | None | $602.56 | $707.95 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $114.82 Typical High $154.88 | Professional | 80 · Assistant surgeon | $97.72 | $114.82 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $100.00 Typical High $138.04 | Professional | AS · PA/NP assist | $85.11 | $100.00 | $138.04 |
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 $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
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 $1,584.89 | Professional | None | $724.44 | $724.44 | $1,584.89 |
Emblem Health Setting Facility Modifier None Typical Low $724.44 Median $1,047.13 Typical High $2,818.38 | Facility | None | $724.44 | $1,047.13 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,258.93 | Professional | None | $676.08 | $794.33 | $1,258.93 |
Excellus BCBS Setting Professional Modifier None Typical Low $416.87 Median $645.65 Typical High $977.24 | Professional | None | $416.87 | $645.65 | $977.24 |
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 $776.25 Median $912.01 Typical High $1,862.09 | Professional | None | $776.25 | $912.01 | $1,862.09 |
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 $478.63 Median $758.58 Typical High $1,778.28 | Professional | None | $478.63 | $758.58 | $1,778.28 |
Univera Setting Facility Modifier None Typical Low $489.78 Median $676.08 Typical High $2,951.21 | Facility | None | $489.78 | $676.08 | $2,951.21 |
Univera Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $977.24 | Professional | None | $489.78 | $645.65 | $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 $380.19 Median $380.19 Typical High $389.05 | Professional | 52 · Reduced service | $380.19 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $154.88 | Professional | 53 · Discontinued | $151.36 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $575.44 | Professional | 54 · Surgery only | $562.34 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $537.03 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $501.19 Typical High $776.25 | Professional | 54 · Surgery only | $331.13 | $501.19 | $776.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $134.90 Typical High $204.17 | Professional | 55 · Aftercare only | $89.13 | $134.90 | $204.17 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $64.57 Typical High $97.72 | Professional | 56 · Pre-op care only | $41.69 | $64.57 | $97.72 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $446.68 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $288.40 | $446.68 | $676.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $398.11 Typical High $575.44 | Professional | 53 · Discontinued | $389.05 | $398.11 | $575.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $501.19 Typical High $776.25 | Professional | 54 · Surgery only | $331.13 | $501.19 | $776.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $134.90 Typical High $407.38 | Professional | 55 · Aftercare only | $89.13 | $134.90 | $407.38 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $64.57 Typical High $190.55 | Professional | 56 · Pre-op care only | $41.69 | $64.57 | $190.55 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $446.68 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $288.40 | $446.68 | $676.08 |
Where New York sits
The same service costs 8.5 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· 46th of 51
$724
AK $3,020TX $355
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.