How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,202 to $11,220Professionalmedian $676 · 10th to 90th $562 to $1,148
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 $1,659.59 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,659.59 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $758.58 | Professional | None | $676.08 | $676.08 | $758.58 |
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 $575.44 Median $676.08 Typical High $933.25 | Professional | None | $575.44 | $676.08 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,023.29 Typical High $1,412.54 | Professional | 50 · Both sides | $870.96 | $1,023.29 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $107.15 Typical High $151.36 | Professional | 80 · Assistant surgeon | $91.20 | $107.15 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $95.50 Typical High $131.83 | Professional | AS · PA/NP assist | $81.28 | $95.50 | $131.83 |
CDPHP Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $6,025.60 Typical High $12,022.64 | Facility | None | $1,445.44 | $6,025.60 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,584.89 | Professional | None | $691.83 | $691.83 | $1,584.89 |
Emblem Health Setting Facility Modifier None Typical Low $794.33 Median $977.24 Typical High $2,754.23 | Facility | None | $794.33 | $977.24 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,202.26 | Professional | None | $645.65 | $794.33 | $1,202.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $398.11 Median $630.96 Typical High $933.25 | Professional | None | $398.11 | $630.96 | $933.25 |
MVP Health Care Setting Facility Modifier None Typical Low $812.83 Median $4,786.30 Typical High $5,754.40 | Facility | None | $812.83 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,778.28 | Professional | None | $724.44 | $954.99 | $1,778.28 |
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 $478.63 Median $724.44 Typical High $1,698.24 | Professional | None | $478.63 | $724.44 | $1,698.24 |
Univera Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $2,754.23 | Facility | None | $467.74 | $645.65 | $2,754.23 |
Univera Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $933.25 | Professional | None | $467.74 | $630.96 | $933.25 |
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 $338.84 Median $338.84 Typical High $380.19 | Professional | 52 · Reduced service | $338.84 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | 53 · Discontinued | $134.90 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $562.34 | Professional | 54 · Surgery only | $501.19 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $75.86 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $467.74 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $467.74 | $467.74 | $524.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $489.78 Typical High $741.31 | Professional | 54 · Surgery only | $316.23 | $489.78 | $741.31 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $131.83 Typical High $194.98 | Professional | 55 · Aftercare only | $85.11 | $131.83 | $194.98 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $63.10 Typical High $93.33 | Professional | 56 · Pre-op care only | $39.81 | $63.10 | $93.33 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $436.52 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $275.42 | $436.52 | $645.65 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $371.54 Typical High $549.54 | Professional | 53 · Discontinued | $363.08 | $371.54 | $549.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $489.78 Typical High $741.31 | Professional | 54 · Surgery only | $316.23 | $489.78 | $741.31 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $131.83 Typical High $389.05 | Professional | 55 · Aftercare only | $85.11 | $131.83 | $389.05 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $63.10 Typical High $181.97 | Professional | 56 · Pre-op care only | $39.81 | $63.10 | $181.97 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $436.52 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $275.42 | $436.52 | $645.65 |
Where New York sits
The same service costs 8.7 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
$676
AK $2,884TX $331
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.