How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,230 to $11,482Professionalmedian $794 · 10th to 90th $575 to $1,288
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 $1,288.25 Median $5,888.44 Typical High $11,748.98 | Facility | None | $1,288.25 | $5,888.44 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $851.14 | Professional | None | $630.96 | $831.76 | $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 $724.44 Median $851.14 Typical High $1,071.52 | Professional | None | $724.44 | $851.14 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $169.82 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $120.23 Typical High $147.91 | Professional | AS · PA/NP assist | $100.00 | $120.23 | $147.91 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,122.02 | Professional | None | $851.14 | $851.14 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,445.44 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,698.24 | Professional | None | $575.44 | $776.25 | $1,698.24 |
Emblem Health Setting Facility Modifier None Typical Low $602.56 Median $758.58 Typical High $2,290.87 | Facility | None | $602.56 | $758.58 | $2,290.87 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,445.44 | Professional | None | $741.31 | $954.99 | $1,445.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $446.68 Median $758.58 Typical High $1,023.29 | Professional | None | $446.68 | $758.58 | $1,023.29 |
Highmark BCBS Setting Facility Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $9,120.11 | Facility | None | $9,120.11 | $9,120.11 | $9,120.11 |
MVP Health Care Setting Facility Modifier None Typical Low $660.69 Median $4,786.30 Typical High $5,754.40 | Facility | None | $660.69 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,995.26 | Professional | None | $676.08 | $676.08 | $1,995.26 |
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 $467.74 Median $724.44 Typical High $1,513.56 | Professional | None | $467.74 | $724.44 | $1,513.56 |
Univera Setting Facility Modifier None Typical Low $407.38 Median $741.31 Typical High $2,630.27 | Facility | None | $407.38 | $741.31 | $2,630.27 |
Univera Setting Professional Modifier None Typical Low $524.81 Median $741.31 Typical High $1,023.29 | Professional | None | $524.81 | $741.31 | $1,023.29 |
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 $316.23 Median $416.87 Typical High $426.58 | Professional | 52 · Reduced service | $316.23 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $165.96 Typical High $173.78 | Professional | 53 · Discontinued | $125.89 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $616.60 Typical High $645.65 | Professional | 54 · Surgery only | $478.63 | $616.60 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $125.89 Typical High $128.82 | Professional | 55 · Aftercare only | $95.50 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $83.18 Typical High $85.11 | Professional | 56 · Pre-op care only | $63.10 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $575.44 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $446.68 | $575.44 | $602.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $602.56 Typical High $870.96 | Professional | 54 · Surgery only | $354.81 | $602.56 | $870.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $162.18 Typical High $229.09 | Professional | 55 · Aftercare only | $93.33 | $162.18 | $229.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $75.86 Typical High $109.65 | Professional | 56 · Pre-op care only | $44.67 | $75.86 | $109.65 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $524.81 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $309.03 | $524.81 | $758.58 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $426.58 Typical High $616.60 | Professional | 53 · Discontinued | $416.87 | $426.58 | $616.60 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $602.56 Typical High $812.83 | Professional | 54 · Surgery only | $354.81 | $602.56 | $812.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $162.18 Typical High $380.19 | Professional | 55 · Aftercare only | $93.33 | $162.18 | $380.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $75.86 Typical High $181.97 | Professional | 56 · Pre-op care only | $44.67 | $75.86 | $181.97 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $524.81 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $309.03 | $524.81 | $741.31 |
Where New York sits
The same service costs 6.2 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· 36th of 51
$794
AK $3,020TX $490
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.