How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,318 to $12,589Professionalmedian $851 · 10th to 90th $676 to $1,349
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 $891.25 Median $891.25 Typical High $977.24 | Professional | None | $891.25 | $891.25 | $977.24 |
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 $1,148.15 | Professional | None | $724.44 | $851.14 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $181.97 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $120.23 Typical High $162.18 | Professional | AS · PA/NP assist | $102.33 | $120.23 | $162.18 |
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 $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $8,128.31 Typical High $16,218.10 | Facility | None | $1,737.80 | $8,128.31 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,862.09 | Professional | None | $776.25 | $776.25 | $1,862.09 |
Emblem Health Setting Facility Modifier None Typical Low $891.25 Median $1,202.26 Typical High $3,162.28 | Facility | None | $891.25 | $1,202.26 | $3,162.28 |
Emblem Health Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,380.38 | Professional | None | $758.58 | $912.01 | $1,380.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $1,122.02 | Professional | None | $478.63 | $741.31 | $1,122.02 |
MVP Health Care Setting Facility Modifier None Typical Low $891.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $891.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $2,089.30 | Professional | None | $891.25 | $1,122.02 | $2,089.30 |
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 $537.03 Median $831.76 Typical High $1,995.26 | Professional | None | $537.03 | $831.76 | $1,995.26 |
Univera Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $3,467.37 | Facility | None | $562.34 | $758.58 | $3,467.37 |
Univera Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,122.02 | Professional | None | $562.34 | $741.31 | $1,122.02 |
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 $446.68 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $446.68 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $660.69 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $616.60 | $630.96 | $630.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $575.44 Typical High $891.25 | Professional | 54 · Surgery only | $380.19 | $575.44 | $891.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $154.88 Typical High $234.42 | Professional | 55 · Aftercare only | $102.33 | $154.88 | $234.42 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $74.13 Typical High $112.20 | Professional | 56 · Pre-op care only | $47.86 | $74.13 | $112.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $512.86 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $331.13 | $512.86 | $776.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $457.09 Typical High $660.69 | Professional | 53 · Discontinued | $446.68 | $457.09 | $660.69 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $575.44 Typical High $891.25 | Professional | 54 · Surgery only | $380.19 | $575.44 | $891.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $154.88 Typical High $467.74 | Professional | 55 · Aftercare only | $102.33 | $154.88 | $467.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $74.13 Typical High $218.78 | Professional | 56 · Pre-op care only | $47.86 | $74.13 | $218.78 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $512.86 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $331.13 | $512.86 | $776.25 |
Where New York sits
The same service costs 17.8 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
$851
AK $3,388TX $191
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.