How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,349 to $14,125Professionalmedian $891 · 10th to 90th $708 to $1,514
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 $933.25 Median $933.25 Typical High $977.24 | Professional | None | $933.25 | $933.25 | $977.24 |
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 $724.44 Median $851.14 Typical High $1,230.27 | Professional | None | $724.44 | $851.14 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,258.93 Typical High $1,862.09 | Professional | 50 · Both sides | $1,071.52 | $1,258.93 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $194.98 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $117.49 Typical High $173.78 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $173.78 |
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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $5,888.44 Typical High $12,022.64 | Facility | None | $1,479.11 | $5,888.44 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $2,089.30 | Professional | None | $912.01 | $912.01 | $2,089.30 |
Emblem Health Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $3,311.31 | Facility | None | $645.65 | $1,047.13 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,584.89 | Professional | None | $851.14 | $851.14 | $1,584.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $1,202.26 | Professional | None | $524.81 | $812.83 | $1,202.26 |
MVP Health Care Setting Facility Modifier None Typical Low $1,071.52 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,071.52 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $954.99 Median $1,380.38 Typical High $2,344.23 | Professional | None | $954.99 | $1,380.38 | $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 $933.25 Typical High $2,238.72 | Professional | None | $616.60 | $933.25 | $2,238.72 |
Univera Setting Facility Modifier None Typical Low $616.60 Median $851.14 Typical High $4,786.30 | Facility | None | $616.60 | $851.14 | $4,786.30 |
Univera Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,202.26 | Professional | None | $616.60 | $812.83 | $1,202.26 |
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 $467.74 Median $467.74 Typical High $489.78 | Professional | 52 · Reduced service | $467.74 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $194.98 | Professional | 53 · Discontinued | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $741.31 | Professional | 54 · Surgery only | $707.95 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $97.72 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $691.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $630.96 Typical High $954.99 | Professional | 54 · Surgery only | $416.87 | $630.96 | $954.99 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $169.82 Typical High $251.19 | Professional | 55 · Aftercare only | $109.65 | $169.82 | $251.19 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $81.28 Typical High $120.23 | Professional | 56 · Pre-op care only | $52.48 | $81.28 | $120.23 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $562.34 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $363.08 | $562.34 | $831.76 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $489.78 Typical High $707.95 | Professional | 53 · Discontinued | $478.63 | $489.78 | $707.95 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $630.96 Typical High $954.99 | Professional | 54 · Surgery only | $416.87 | $630.96 | $954.99 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $169.82 Typical High $501.19 | Professional | 55 · Aftercare only | $109.65 | $169.82 | $501.19 |
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 14.5 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
$891
AK $3,715TX $257
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.