How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,202 to $10,715Professionalmedian $661 · 10th to 90th $550 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 $1,698.24 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,698.24 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | None | $630.96 | $630.96 | $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 $562.34 Median $660.69 Typical High $912.01 | Professional | None | $562.34 | $660.69 | $912.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $977.24 Typical High $1,380.38 | Professional | 50 · Both sides | $831.76 | $977.24 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $104.71 Typical High $144.54 | Professional | 80 · Assistant surgeon | $89.13 | $104.71 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $91.20 Typical High $128.82 | Professional | AS · PA/NP assist | $77.62 | $91.20 | $128.82 |
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 $2,754.23 Typical High $5,623.41 | Facility | None | $1,445.44 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,548.82 | Professional | None | $707.95 | $707.95 | $1,548.82 |
Emblem Health Setting Facility Modifier None Typical Low $741.31 Median $1,023.29 Typical High $2,818.38 | Facility | None | $741.31 | $1,023.29 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,230.27 | Professional | None | $660.69 | $812.83 | $1,230.27 |
Excellus BCBS Setting Professional Modifier None Typical Low $407.38 Median $645.65 Typical High $933.25 | Professional | None | $407.38 | $645.65 | $933.25 |
MVP Health Care Setting Facility Modifier None Typical Low $691.83 Median $4,786.30 Typical High $5,754.40 | Facility | None | $691.83 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $724.44 Median $977.24 Typical High $1,778.28 | Professional | None | $724.44 | $977.24 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $12,589.25 | Facility | None | $1,318.26 | $4,073.80 | $12,589.25 |
United Setting Professional Modifier None Typical Low $489.78 Median $724.44 Typical High $1,584.89 | Professional | None | $489.78 | $724.44 | $1,584.89 |
Univera Setting Facility Modifier None Typical Low $478.63 Median $660.69 Typical High $2,818.38 | Facility | None | $478.63 | $660.69 | $2,818.38 |
Univera Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $933.25 | Professional | None | $478.63 | $645.65 | $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 $309.03 Median $309.03 Typical High $371.54 | Professional | 52 · Reduced service | $309.03 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $562.34 | Professional | 54 · Surgery only | $467.74 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $112.20 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $524.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $512.86 Typical High $741.31 | Professional | 54 · Surgery only | $323.59 | $512.86 | $741.31 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $134.90 Typical High $199.53 | Professional | 55 · Aftercare only | $85.11 | $134.90 | $199.53 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $64.57 Typical High $93.33 | Professional | 56 · Pre-op care only | $40.74 | $64.57 | $93.33 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $446.68 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $281.84 | $446.68 | $645.65 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $371.54 Typical High $537.03 | Professional | 53 · Discontinued | $363.08 | $371.54 | $537.03 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $512.86 Typical High $741.31 | Professional | 54 · Surgery only | $323.59 | $512.86 | $741.31 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $134.90 Typical High $389.05 | Professional | 55 · Aftercare only | $85.11 | $134.90 | $389.05 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $64.57 Typical High $186.21 | Professional | 56 · Pre-op care only | $40.74 | $64.57 | $186.21 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $446.68 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $281.84 | $446.68 | $660.69 |
Where New York sits
The same service costs 19.5 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
$661
AK $2,951TX $151
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.