How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,318 to $14,125Professionalmedian $676 · 10th to 90th $537 to $1,122
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 $12,589.25 | Facility | None | $1,819.70 | $6,309.57 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $776.25 | Professional | None | $691.83 | $691.83 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $912.01 | Professional | None | $549.54 | $660.69 | $912.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $977.24 Typical High $1,348.96 | Professional | 50 · Both sides | $831.76 | $977.24 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $104.71 Typical High $144.54 | Professional | 80 · Assistant surgeon | $89.13 | $104.71 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $91.20 Typical High $125.89 | Professional | AS · PA/NP assist | $77.62 | $91.20 | $125.89 |
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 $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
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 $676.08 Median $676.08 Typical High $1,548.82 | Professional | None | $676.08 | $676.08 | $1,548.82 |
Emblem Health Setting Facility Modifier None Typical Low $741.31 Median $1,000.00 Typical High $2,691.53 | Facility | None | $741.31 | $1,000.00 | $2,691.53 |
Emblem Health Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,174.90 | Professional | None | $630.96 | $758.58 | $1,174.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $912.01 | Professional | None | $389.05 | $616.60 | $912.01 |
MVP Health Care Setting Facility Modifier None Typical Low $691.83 Median $4,786.30 Typical High $5,754.40 | Facility | None | $691.83 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,737.80 | Professional | None | $707.95 | $977.24 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,162.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $1,659.59 | Professional | None | $457.09 | $707.95 | $1,659.59 |
Univera Setting Facility Modifier None Typical Low $457.09 Median $630.96 Typical High $3,019.95 | Facility | None | $457.09 | $630.96 | $3,019.95 |
Univera Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $912.01 | Professional | None | $457.09 | $616.60 | $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 $346.74 Median $346.74 Typical High $354.81 | Professional | 52 · Reduced service | $346.74 | $346.74 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 53 · Discontinued | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $537.03 | Professional | 54 · Surgery only | $524.81 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $107.15 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $70.79 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $501.19 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $478.63 Typical High $758.58 | Professional | 54 · Surgery only | $309.03 | $478.63 | $758.58 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $128.82 Typical High $204.17 | Professional | 55 · Aftercare only | $81.28 | $128.82 | $204.17 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $61.66 Typical High $95.50 | Professional | 56 · Pre-op care only | $38.90 | $61.66 | $95.50 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $416.87 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $269.15 | $416.87 | $660.69 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $363.08 Typical High $524.81 | Professional | 53 · Discontinued | $354.81 | $363.08 | $524.81 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $478.63 Typical High $707.95 | Professional | 54 · Surgery only | $309.03 | $478.63 | $707.95 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $128.82 Typical High $363.08 | Professional | 55 · Aftercare only | $81.28 | $128.82 | $363.08 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $61.66 Typical High $173.78 | Professional | 56 · Pre-op care only | $38.90 | $61.66 | $173.78 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $416.87 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $269.15 | $416.87 | $630.96 |
Where New York sits
The same service costs 7.8 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· 45th of 51
$676
AK $2,818TX $363
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.