How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,288 to $11,482Professionalmedian $708 · 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 $6,165.95 Typical High $11,748.98 | Facility | None | $1,819.70 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $831.76 | Professional | None | $741.31 | $776.25 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,000.00 | Professional | None | $588.84 | $691.83 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,047.13 Typical High $1,513.56 | Professional | 50 · Both sides | $891.25 | $1,047.13 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $109.65 Typical High $158.49 | Professional | 80 · Assistant surgeon | $93.33 | $109.65 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $97.72 Typical High $141.25 | Professional | AS · PA/NP assist | $83.18 | $97.72 | $141.25 |
CDPHP Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,445.44 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,659.59 | Professional | None | $741.31 | $741.31 | $1,659.59 |
Emblem Health Setting Facility Modifier None Typical Low $812.83 Median $1,230.27 Typical High $2,754.23 | Facility | None | $812.83 | $1,230.27 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,230.27 | Professional | None | $660.69 | $794.33 | $1,230.27 |
Excellus BCBS Setting Professional Modifier None Typical Low $398.11 Median $630.96 Typical High $912.01 | Professional | None | $398.11 | $630.96 | $912.01 |
MVP Health Care Setting Facility Modifier None Typical Low $912.01 Median $4,786.30 Typical High $5,754.40 | Facility | None | $912.01 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,819.70 | Professional | None | $741.31 | $1,122.02 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,073.80 | $14,125.38 |
United Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $1,737.80 | Professional | None | $489.78 | $741.31 | $1,737.80 |
Univera Setting Facility Modifier None Typical Low $467.74 Median $660.69 Typical High $3,715.35 | Facility | None | $467.74 | $660.69 | $3,715.35 |
Univera Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $912.01 | Professional | None | $467.74 | $630.96 | $912.01 |
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 $371.54 Median $389.05 Typical High $416.87 | Professional | 52 · Reduced service | $371.54 | $389.05 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $154.88 Typical High $165.96 | Professional | 53 · Discontinued | $147.91 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $588.84 Typical High $630.96 | Professional | 54 · Surgery only | $549.54 | $588.84 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $117.49 Typical High $125.89 | Professional | 55 · Aftercare only | $109.65 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $77.62 Typical High $83.18 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $549.54 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $512.86 | $549.54 | $588.84 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $501.19 Typical High $776.25 | Professional | 54 · Surgery only | $316.23 | $501.19 | $776.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $131.83 Typical High $208.93 | Professional | 55 · Aftercare only | $83.18 | $131.83 | $208.93 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $63.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $39.81 | $63.10 | $97.72 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $436.52 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $275.42 | $436.52 | $676.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $380.19 Typical High $549.54 | Professional | 53 · Discontinued | $371.54 | $380.19 | $549.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $501.19 Typical High $724.44 | Professional | 54 · Surgery only | $316.23 | $501.19 | $724.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $131.83 Typical High $371.54 | Professional | 55 · Aftercare only | $83.18 | $131.83 | $371.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $63.10 Typical High $177.83 | Professional | 56 · Pre-op care only | $39.81 | $63.10 | $177.83 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $436.52 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $275.42 | $436.52 | $660.69 |
Where New York sits
The same service costs 7.2 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· 45th of 51
$724
AK $2,884TX $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.