How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,349 to $14,454Professionalmedian $851 · 10th to 90th $676 to $1,413
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 $11,481.54 | Facility | None | $1,819.70 | $5,754.40 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $891.25 | Professional | None | $870.96 | $870.96 | $891.25 |
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 $707.95 Median $831.76 Typical High $1,174.90 | Professional | None | $707.95 | $831.76 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,258.93 Typical High $1,737.80 | Professional | 50 · Both sides | $1,071.52 | $1,258.93 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $131.83 Typical High $186.21 | Professional | 80 · Assistant surgeon | $112.20 | $131.83 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $117.49 Typical High $162.18 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $162.18 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $5,888.44 Typical High $12,022.64 | Facility | None | $1,380.38 | $5,888.44 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,905.46 | Professional | None | $851.14 | $851.14 | $1,905.46 |
Emblem Health Setting Facility Modifier None Typical Low $776.25 Median $977.24 Typical High $3,235.94 | Facility | None | $776.25 | $977.24 | $3,235.94 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,479.11 | Professional | None | $794.33 | $954.99 | $1,479.11 |
Excellus BCBS Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $1,122.02 | Professional | None | $489.78 | $758.58 | $1,122.02 |
MVP Health Care Setting Facility Modifier None Typical Low $851.14 Median $5,754.40 Typical High $23,442.29 | Facility | None | $851.14 | $5,754.40 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $2,187.76 | Professional | None | $891.25 | $1,230.27 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,168.69 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,168.69 | $14,125.38 |
United Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $2,089.30 | Professional | None | $575.44 | $891.25 | $2,089.30 |
Univera Setting Facility Modifier None Typical Low $575.44 Median $794.33 Typical High $3,388.44 | Facility | None | $575.44 | $794.33 | $3,388.44 |
Univera Setting Professional Modifier None Typical Low $575.44 Median $758.58 Typical High $1,122.02 | Professional | None | $575.44 | $758.58 | $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 $436.52 Median $436.52 Typical High $446.68 | Professional | 52 · Reduced service | $436.52 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $177.83 | Professional | 53 · Discontinued | $173.78 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $676.08 | Professional | 54 · Surgery only | $645.65 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $134.90 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $89.13 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $630.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $602.56 Typical High $954.99 | Professional | 54 · Surgery only | $389.05 | $602.56 | $954.99 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $158.49 Typical High $257.04 | Professional | 55 · Aftercare only | $102.33 | $158.49 | $257.04 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $75.86 Typical High $120.23 | Professional | 56 · Pre-op care only | $48.98 | $75.86 | $120.23 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $524.81 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $338.84 | $524.81 | $831.76 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $457.09 Typical High $676.08 | Professional | 53 · Discontinued | $446.68 | $457.09 | $676.08 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $602.56 Typical High $891.25 | Professional | 54 · Surgery only | $389.05 | $602.56 | $891.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $158.49 Typical High $457.09 | Professional | 55 · Aftercare only | $102.33 | $158.49 | $457.09 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $75.86 Typical High $218.78 | Professional | 56 · Pre-op care only | $48.98 | $75.86 | $218.78 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $524.81 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $338.84 | $524.81 | $794.33 |
Where New York sits
The same service costs 8.1 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 $3,548TX $437
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.