How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,288 to $12,589Professionalmedian $891 · 10th to 90th $724 to $1,479
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 $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | None | $812.83 | $812.83 | $977.24 |
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 $758.58 Median $891.25 Typical High $1,174.90 | Professional | None | $758.58 | $891.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,348.96 Typical High $1,698.24 | Professional | 50 · Both sides | $1,148.15 | $1,348.96 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $144.54 Typical High $181.97 | Professional | 80 · Assistant surgeon | $123.03 | $144.54 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $125.89 Typical High $158.49 | Professional | AS · PA/NP assist | $107.15 | $125.89 | $158.49 |
CDPHP Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $15,135.61 Typical High $30,902.95 | Facility | None | $1,513.56 | $15,135.61 | $30,902.95 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,995.26 | Professional | None | $933.25 | $933.25 | $1,995.26 |
Emblem Health Setting Facility Modifier None Typical Low $977.24 Median $1,148.15 Typical High $3,548.13 | Facility | None | $977.24 | $1,148.15 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,584.89 | Professional | None | $851.14 | $1,023.29 | $1,584.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $1,230.27 | Professional | None | $524.81 | $812.83 | $1,230.27 |
MVP Health Care Setting Facility Modifier None Typical Low $812.83 Median $4,786.30 Typical High $5,754.40 | Facility | None | $812.83 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $2,344.23 | Professional | None | $977.24 | $1,348.96 | $2,344.23 |
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 $616.60 Median $954.99 Typical High $2,137.96 | Professional | None | $616.60 | $954.99 | $2,137.96 |
Univera Setting Facility Modifier None Typical Low $616.60 Median $851.14 Typical High $3,715.35 | Facility | None | $616.60 | $851.14 | $3,715.35 |
Univera Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,230.27 | Professional | None | $616.60 | $812.83 | $1,230.27 |
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 $407.38 Median $407.38 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $194.98 | Professional | 53 · Discontinued | $162.18 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | 54 · Surgery only | $602.56 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $676.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $645.65 Typical High $977.24 | Professional | 54 · Surgery only | $416.87 | $645.65 | $977.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $169.82 Typical High $257.04 | Professional | 55 · Aftercare only | $112.20 | $169.82 | $257.04 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $81.28 Typical High $123.03 | Professional | 56 · Pre-op care only | $52.48 | $81.28 | $123.03 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $562.34 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $363.08 | $562.34 | $851.14 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $724.44 | Professional | 53 · Discontinued | $489.78 | $489.78 | $724.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $645.65 Typical High $977.24 | Professional | 54 · Surgery only | $416.87 | $645.65 | $977.24 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $169.82 Typical High $512.86 | Professional | 55 · Aftercare only | $112.20 | $169.82 | $512.86 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $81.28 Typical High $239.88 | Professional | 56 · Pre-op care only | $52.48 | $81.28 | $239.88 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $562.34 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $363.08 | $562.34 | $851.14 |
Where New York sits
The same service costs 16.2 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· 44th of 51
$891
AK $3,802TX $234
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.