How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,288 to $10,471Professionalmedian $933 · 10th to 90th $776 to $1,660
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 $870.96 Median $870.96 Typical High $1,096.48 | Professional | None | $870.96 | $870.96 | $1,096.48 |
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 $794.33 Median $933.25 Typical High $1,348.96 | Professional | None | $794.33 | $933.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,412.54 Typical High $1,995.26 | Professional | 50 · Both sides | $1,202.26 | $1,412.54 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $151.36 Typical High $213.80 | Professional | 80 · Assistant surgeon | $128.82 | $151.36 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $131.83 Typical High $186.21 | Professional | AS · PA/NP assist | $112.20 | $131.83 | $186.21 |
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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $5,888.44 Typical High $12,022.64 | Facility | None | $1,621.81 | $5,888.44 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,000.00 | $2,344.23 |
Emblem Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $3,630.78 | Facility | None | $1,023.29 | $1,230.27 | $3,630.78 |
Emblem Health Setting Professional Modifier None Typical Low $933.25 Median $1,122.02 Typical High $1,737.80 | Professional | None | $933.25 | $1,122.02 | $1,737.80 |
Excellus BCBS Setting Professional Modifier None Typical Low $575.44 Median $891.25 Typical High $1,318.26 | Professional | None | $575.44 | $891.25 | $1,318.26 |
MVP Health Care Setting Facility Modifier None Typical Low $1,174.90 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,174.90 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,047.13 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,621.81 | $2,570.40 |
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 $676.08 Median $1,047.13 Typical High $2,454.71 | Professional | None | $676.08 | $1,047.13 | $2,454.71 |
Univera Setting Facility Modifier None Typical Low $676.08 Median $933.25 Typical High $5,011.87 | Facility | None | $676.08 | $933.25 | $5,011.87 |
Univera Setting Professional Modifier None Typical Low $676.08 Median $891.25 Typical High $1,318.26 | Professional | None | $676.08 | $891.25 | $1,318.26 |
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 $436.52 Median $436.52 Typical High $549.54 | Professional | 52 · Reduced service | $436.52 | $436.52 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $218.78 | Professional | 53 · Discontinued | $173.78 | $173.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $831.76 | Professional | 54 · Surgery only | $660.69 | $660.69 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $165.96 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $109.65 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $776.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $707.95 Typical High $1,122.02 | Professional | 54 · Surgery only | $457.09 | $707.95 | $1,122.02 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $186.21 Typical High $302.00 | Professional | 55 · Aftercare only | $120.23 | $186.21 | $302.00 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $89.13 Typical High $141.25 | Professional | 56 · Pre-op care only | $57.54 | $89.13 | $141.25 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $616.60 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $398.11 | $616.60 | $977.24 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $537.03 Typical High $794.33 | Professional | 53 · Discontinued | $524.81 | $537.03 | $794.33 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $707.95 Typical High $1,047.13 | Professional | 54 · Surgery only | $457.09 | $707.95 | $1,047.13 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $186.21 Typical High $537.03 | Professional | 55 · Aftercare only | $120.23 | $186.21 | $537.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $89.13 Typical High $257.04 | Professional | 56 · Pre-op care only | $57.54 | $89.13 | $257.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $616.60 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $398.11 | $616.60 | $933.25 |
Where New York sits
The same service costs 8.3 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
$955
AK $4,169TX $501
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.