How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,318 to $14,791Professionalmedian $741 · 10th to 90th $589 to $1,230
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 $758.58 Median $758.58 Typical High $831.76 | Professional | None | $758.58 | $758.58 | $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 $602.56 Median $707.95 Typical High $1,000.00 | Professional | None | $602.56 | $707.95 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,071.52 Typical High $1,479.11 | Professional | 50 · Both sides | $912.01 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $114.82 Typical High $158.49 | Professional | 80 · Assistant surgeon | $97.72 | $114.82 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $100.00 Typical High $138.04 | Professional | AS · PA/NP assist | $85.11 | $100.00 | $138.04 |
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 $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $13,803.84 Typical High $28,183.83 | Facility | None | $1,318.26 | $13,803.84 | $28,183.83 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,698.24 | Professional | None | $741.31 | $741.31 | $1,698.24 |
Emblem Health Setting Facility Modifier None Typical Low $660.69 Median $851.14 Typical High $2,754.23 | Facility | None | $660.69 | $851.14 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,288.25 | Professional | None | $676.08 | $831.76 | $1,288.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $426.58 Median $660.69 Typical High $977.24 | Professional | None | $426.58 | $660.69 | $977.24 |
MVP Health Care Setting Facility Modifier None Typical Low $912.01 Median $4,786.30 Typical High $5,754.40 | Facility | None | $912.01 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $776.25 Median $1,174.90 Typical High $1,862.09 | Professional | None | $776.25 | $1,174.90 | $1,862.09 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,302.69 | Facility | None | $1,318.26 | $3,548.13 | $12,302.69 |
United Setting Professional Modifier None Typical Low $501.19 Median $758.58 Typical High $1,819.70 | Professional | None | $501.19 | $758.58 | $1,819.70 |
Univera Setting Facility Modifier None Typical Low $501.19 Median $676.08 Typical High $2,951.21 | Facility | None | $501.19 | $676.08 | $2,951.21 |
Univera Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $977.24 | Professional | None | $501.19 | $660.69 | $977.24 |
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 $380.19 Median $380.19 Typical High $407.38 | Professional | 52 · Reduced service | $380.19 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $165.96 | Professional | 53 · Discontinued | $151.36 | $151.36 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $616.60 | Professional | 54 · Surgery only | $575.44 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $123.03 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $83.18 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $575.44 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $524.81 Typical High $776.25 | Professional | 54 · Surgery only | $331.13 | $524.81 | $776.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $138.04 Typical High $204.17 | Professional | 55 · Aftercare only | $89.13 | $138.04 | $204.17 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $66.07 Typical High $97.72 | Professional | 56 · Pre-op care only | $42.66 | $66.07 | $97.72 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $457.09 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $295.12 | $457.09 | $676.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $575.44 | Professional | 53 · Discontinued | $389.05 | $389.05 | $575.44 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $524.81 Typical High $776.25 | Professional | 54 · Surgery only | $331.13 | $524.81 | $776.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $138.04 Typical High $407.38 | Professional | 55 · Aftercare only | $89.13 | $138.04 | $407.38 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $66.07 Typical High $194.98 | Professional | 56 · Pre-op care only | $42.66 | $66.07 | $194.98 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $457.09 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $295.12 | $457.09 | $676.08 |
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
$741
AK $3,020TX $380
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.