How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,349 to $14,454Professionalmedian $912 · 10th to 90th $741 to $1,549
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 $1,819.70 | Professional | None | $933.25 | $933.25 | $1,819.70 |
Ambetter Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,230.27 | Professional | None | $758.58 | $891.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,318.26 Typical High $1,862.09 | Professional | 50 · Both sides | $1,122.02 | $1,318.26 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $141.25 Typical High $194.98 | Professional | 80 · Assistant surgeon | $120.23 | $141.25 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $123.03 Typical High $173.78 | Professional | AS · PA/NP assist | $104.71 | $123.03 | $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 $10,964.78 Typical High $22,387.21 | Facility | None | $1,479.11 | $10,964.78 | $22,387.21 |
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 $1,023.29 Median $1,318.26 Typical High $3,548.13 | Facility | None | $1,023.29 | $1,318.26 | $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 $1,202.26 | Professional | None | $524.81 | $812.83 | $1,202.26 |
MVP Health Care Setting Facility Modifier None Typical Low $1,096.48 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,096.48 | $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 $3,548.13 Typical High $12,589.25 | Facility | None | $1,318.26 | $3,548.13 | $12,589.25 |
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 $3,890.45 | Facility | None | $616.60 | $851.14 | $3,890.45 |
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 $501.19 | Professional | 52 · Reduced service | $467.74 | $467.74 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $199.53 | Professional | 53 · Discontinued | $186.21 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $707.95 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $100.00 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $707.95 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $630.96 Typical High $1,023.29 | Professional | 54 · Surgery only | $416.87 | $630.96 | $1,023.29 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $169.82 Typical High $269.15 | Professional | 55 · Aftercare only | $109.65 | $169.82 | $269.15 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $81.28 Typical High $128.82 | Professional | 56 · Pre-op care only | $52.48 | $81.28 | $128.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $562.34 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $363.08 | $562.34 | $891.25 |
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 $489.78 | Professional | 55 · Aftercare only | $109.65 | $169.82 | $489.78 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $81.28 Typical High $234.42 | Professional | 56 · Pre-op care only | $52.48 | $81.28 | $234.42 |
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 7.9 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
$912
AK $3,715TX $468
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.