How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,230 to $11,482Professionalmedian $741 · 10th to 90th $589 to $1,259
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 $5,754.40 Typical High $10,715.19 | Facility | None | $1,819.70 | $5,754.40 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $851.14 | Professional | None | $645.65 | $794.33 | $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 $630.96 Median $741.31 Typical High $1,023.29 | Professional | None | $630.96 | $741.31 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $120.23 Typical High $162.18 | Professional | 80 · Assistant surgeon | $100.00 | $120.23 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $104.71 Typical High $144.54 | Professional | AS · PA/NP assist | $89.13 | $104.71 | $144.54 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,148.15 | Professional | None | $912.01 | $912.01 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,348.96 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,659.59 | Professional | None | $616.60 | $758.58 | $1,659.59 |
Emblem Health Setting Facility Modifier None Typical Low $537.03 Median $707.95 Typical High $2,344.23 | Facility | None | $537.03 | $707.95 | $2,344.23 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,380.38 | Professional | None | $741.31 | $891.25 | $1,380.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $436.52 Median $724.44 Typical High $1,000.00 | Professional | None | $436.52 | $724.44 | $1,000.00 |
MVP Health Care Setting Facility Modifier None Typical Low $630.96 Median $3,235.94 Typical High $4,365.16 | Facility | None | $630.96 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,949.84 | Professional | None | $676.08 | $676.08 | $1,949.84 |
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 $446.68 Median $707.95 Typical High $1,513.56 | Professional | None | $446.68 | $707.95 | $1,513.56 |
Univera Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $3,162.28 | Facility | None | $416.87 | $741.31 | $3,162.28 |
Univera Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,000.00 | Professional | None | $512.86 | $724.44 | $1,000.00 |
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 $323.59 Median $389.05 Typical High $426.58 | Professional | 52 · Reduced service | $323.59 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $154.88 Typical High $169.82 | Professional | 53 · Discontinued | $128.82 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $588.84 Typical High $630.96 | Professional | 54 · Surgery only | $489.78 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $117.49 Typical High $125.89 | Professional | 55 · Aftercare only | $97.72 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $77.62 Typical High $85.11 | Professional | 56 · Pre-op care only | $64.57 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $549.54 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $457.09 | $549.54 | $588.84 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $562.34 Typical High $851.14 | Professional | 54 · Surgery only | $338.84 | $562.34 | $851.14 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $151.36 Typical High $223.87 | Professional | 55 · Aftercare only | $91.20 | $151.36 | $223.87 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $72.44 Typical High $107.15 | Professional | 56 · Pre-op care only | $43.65 | $72.44 | $107.15 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $501.19 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $302.00 | $501.19 | $741.31 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $416.87 Typical High $588.84 | Professional | 53 · Discontinued | $398.11 | $416.87 | $588.84 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $562.34 Typical High $794.33 | Professional | 54 · Surgery only | $338.84 | $562.34 | $794.33 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $151.36 Typical High $389.05 | Professional | 55 · Aftercare only | $91.20 | $151.36 | $389.05 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $72.44 Typical High $186.21 | Professional | 56 · Pre-op care only | $43.65 | $72.44 | $186.21 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $501.19 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $302.00 | $501.19 | $741.31 |
Where New York sits
The same service costs 6.6 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
$741
AK $3,020TX $457
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.