How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,148 to $9,550Professionalmedian $537 · 10th to 90th $447 to $933
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $602.56 | Professional | None | $562.34 | $562.34 | $602.56 |
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 $457.09 Median $537.03 Typical High $741.31 | Professional | None | $457.09 | $537.03 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $812.83 Typical High $1,122.02 | Professional | 50 · Both sides | $691.83 | $812.83 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $87.10 Typical High $117.49 | Professional | 80 · Assistant surgeon | $74.13 | $87.10 | $117.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $75.86 Typical High $104.71 | Professional | AS · PA/NP assist | $64.57 | $75.86 | $104.71 |
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 $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,318.26 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $1,258.93 | Professional | None | $562.34 | $562.34 | $1,258.93 |
Emblem Health Setting Facility Modifier None Typical Low $269.15 Median $645.65 Typical High $2,137.96 | Facility | None | $269.15 | $645.65 | $2,137.96 |
Emblem Health Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $977.24 | Professional | None | $524.81 | $645.65 | $977.24 |
Excellus BCBS Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $758.58 | Professional | None | $331.13 | $512.86 | $758.58 |
MVP Health Care Setting Facility Modifier None Typical Low $562.34 Median $3,235.94 Typical High $4,365.16 | Facility | None | $562.34 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,445.44 | Professional | None | $524.81 | $524.81 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $1,380.38 | Professional | None | $389.05 | $588.84 | $1,380.38 |
Univera Setting Facility Modifier None Typical Low $389.05 Median $524.81 Typical High $2,041.74 | Facility | None | $389.05 | $524.81 | $2,041.74 |
Univera Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $758.58 | Professional | None | $389.05 | $512.86 | $758.58 |
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 $281.84 Median $281.84 Typical High $295.12 | Professional | 52 · Reduced service | $281.84 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $120.23 | Professional | 53 · Discontinued | $112.20 | $112.20 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $446.68 | Professional | 54 · Surgery only | $426.58 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $89.13 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $60.26 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $416.87 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $407.38 Typical High $645.65 | Professional | 54 · Surgery only | $257.04 | $407.38 | $645.65 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $109.65 Typical High $169.82 | Professional | 55 · Aftercare only | $69.18 | $109.65 | $169.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $51.29 Typical High $81.28 | Professional | 56 · Pre-op care only | $33.11 | $51.29 | $81.28 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $354.81 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $223.87 | $354.81 | $562.34 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $302.00 Typical High $436.52 | Professional | 53 · Discontinued | $295.12 | $302.00 | $436.52 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $407.38 Typical High $602.56 | Professional | 54 · Surgery only | $257.04 | $407.38 | $602.56 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $109.65 Typical High $309.03 | Professional | 55 · Aftercare only | $69.18 | $109.65 | $309.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $51.29 Typical High $144.54 | Professional | 56 · Pre-op care only | $33.11 | $51.29 | $144.54 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $354.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $223.87 | $354.81 | $524.81 |
Where New York sits
The same service costs 8.9 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
$562
AK $2,344TX $263
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.