How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,288 to $14,125Professionalmedian $759 · 10th to 90th $589 to $1,288
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 $794.33 Median $794.33 Typical High $1,513.56 | Professional | None | $794.33 | $794.33 | $1,513.56 |
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 $602.56 Median $707.95 Typical High $1,047.13 | Professional | None | $602.56 | $707.95 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,071.52 Typical High $1,548.82 | Professional | 50 · Both sides | $912.01 | $1,071.52 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $114.82 Typical High $165.96 | Professional | 80 · Assistant surgeon | $97.72 | $114.82 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $100.00 Typical High $144.54 | Professional | AS · PA/NP assist | $85.11 | $100.00 | $144.54 |
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 $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $5,888.44 Typical High $12,022.64 | Facility | None | $1,318.26 | $5,888.44 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,778.28 | Professional | None | $758.58 | $758.58 | $1,778.28 |
Emblem Health Setting Facility Modifier None Typical Low $549.54 Median $891.25 Typical High $2,818.38 | Facility | None | $549.54 | $891.25 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,318.26 | Professional | None | $707.95 | $851.14 | $1,318.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $1,023.29 | Professional | None | $436.52 | $676.08 | $1,023.29 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
MVP Health Care Setting Facility Modifier None Typical Low $933.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $933.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,949.84 | Professional | None | $794.33 | $1,096.48 | $1,949.84 |
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 $512.86 Median $794.33 Typical High $1,862.09 | Professional | None | $512.86 | $794.33 | $1,862.09 |
Univera Setting Facility Modifier None Typical Low $512.86 Median $707.95 Typical High $4,073.80 | Facility | None | $512.86 | $707.95 | $4,073.80 |
Univera Setting Professional Modifier None Typical Low $512.86 Median $676.08 Typical High $1,023.29 | Professional | None | $512.86 | $676.08 | $1,023.29 |
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 $398.11 Median $398.11 Typical High $426.58 | Professional | 52 · Reduced service | $398.11 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $169.82 | Professional | 53 · Discontinued | $158.49 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $645.65 | Professional | 54 · Surgery only | $588.84 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $85.11 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $602.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $537.03 Typical High $851.14 | Professional | 54 · Surgery only | $346.74 | $537.03 | $851.14 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $144.54 Typical High $229.09 | Professional | 55 · Aftercare only | $93.33 | $144.54 | $229.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $67.61 Typical High $109.65 | Professional | 56 · Pre-op care only | $43.65 | $67.61 | $109.65 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $467.74 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $302.00 | $467.74 | $758.58 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $407.38 Typical High $602.56 | Professional | 53 · Discontinued | $398.11 | $407.38 | $602.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $537.03 Typical High $812.83 | Professional | 54 · Surgery only | $346.74 | $537.03 | $812.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $144.54 Typical High $407.38 | Professional | 55 · Aftercare only | $93.33 | $144.54 | $407.38 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $67.61 Typical High $194.98 | Professional | 56 · Pre-op care only | $43.65 | $67.61 | $194.98 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $467.74 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $302.00 | $467.74 | $707.95 |
Where New York sits
The same service costs 7.6 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
$759
AK $3,162TX $417
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.