How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,259 to $14,125Professionalmedian $617 · 10th to 90th $501 to $1,023
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 $11,481.54 | Facility | None | $1,819.70 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $660.69 | Professional | None | $630.96 | $630.96 | $660.69 |
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 $512.86 Median $602.56 Typical High $831.76 | Professional | None | $512.86 | $602.56 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $912.01 Typical High $1,258.93 | Professional | 50 · Both sides | $758.58 | $912.01 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $95.50 Typical High $131.83 | Professional | 80 · Assistant surgeon | $81.28 | $95.50 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $85.11 Typical High $114.82 | Professional | AS · PA/NP assist | $70.79 | $85.11 | $114.82 |
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 $891.25 Median $891.25 Typical High $891.25 | Professional | None | $891.25 | $891.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,348.96 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $1,412.54 | Professional | None | $616.60 | $616.60 | $1,412.54 |
Emblem Health Setting Facility Modifier None Typical Low $660.69 Median $1,000.00 Typical High $2,511.89 | Facility | None | $660.69 | $1,000.00 | $2,511.89 |
Emblem Health Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,096.48 | Professional | None | $575.44 | $707.95 | $1,096.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $831.76 | Professional | None | $363.08 | $562.34 | $831.76 |
MVP Health Care Setting Facility Modifier None Typical Low $645.65 Median $4,786.30 Typical High $5,754.40 | Facility | None | $645.65 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $1,584.89 | Professional | None | $645.65 | $891.25 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $9,120.11 | Facility | None | $1,122.02 | $2,754.23 | $9,120.11 |
United Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $1,513.56 | Professional | None | $426.58 | $645.65 | $1,513.56 |
Univera Setting Facility Modifier None Typical Low $426.58 Median $575.44 Typical High $3,235.94 | Facility | None | $426.58 | $575.44 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $831.76 | Professional | None | $426.58 | $562.34 | $831.76 |
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 $316.23 Median $316.23 Typical High $331.13 | Professional | 52 · Reduced service | $316.23 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $131.83 | Professional | 53 · Discontinued | $125.89 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $478.63 Typical High $489.78 | Professional | 54 · Surgery only | $478.63 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $95.50 Typical High $97.72 | Professional | 55 · Aftercare only | $95.50 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $66.07 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $446.68 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $446.68 | $446.68 | $457.09 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $446.68 Typical High $660.69 | Professional | 54 · Surgery only | $281.84 | $446.68 | $660.69 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $120.23 Typical High $173.78 | Professional | 55 · Aftercare only | $75.86 | $120.23 | $173.78 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $56.23 Typical High $83.18 | Professional | 56 · Pre-op care only | $36.31 | $56.23 | $83.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $389.05 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $251.19 | $389.05 | $575.44 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $331.13 Typical High $489.78 | Professional | 53 · Discontinued | $323.59 | $331.13 | $489.78 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $446.68 Typical High $660.69 | Professional | 54 · Surgery only | $281.84 | $446.68 | $660.69 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $120.23 Typical High $346.74 | Professional | 55 · Aftercare only | $75.86 | $120.23 | $346.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $56.23 Typical High $165.96 | Professional | 56 · Pre-op care only | $36.31 | $56.23 | $165.96 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $389.05 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $251.19 | $389.05 | $575.44 |
Where New York sits
The same service costs 8.3 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
$617
AK $2,570TX $309
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.