How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,023 to $9,333Professionalmedian $617 · 10th to 90th $501 to $1,072
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 $1,548.82 Median $4,365.16 Typical High $8,128.31 | Facility | None | $1,548.82 | $4,365.16 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $724.44 | Professional | None | $616.60 | $616.60 | $724.44 |
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 $501.19 Median $588.84 Typical High $870.96 | Professional | None | $501.19 | $588.84 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $95.50 Typical High $138.04 | Professional | 80 · Assistant surgeon | $81.28 | $95.50 | $138.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $83.18 Typical High $120.23 | Professional | AS · PA/NP assist | $70.79 | $83.18 | $120.23 |
CDPHP Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,148.15 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $2,754.23 Typical High $5,370.32 | Facility | None | $1,023.29 | $2,754.23 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,479.11 | Professional | None | $676.08 | $676.08 | $1,479.11 |
Emblem Health Setting Facility Modifier None Typical Low $257.04 Median $812.83 Typical High $2,630.27 | Facility | None | $257.04 | $812.83 | $2,630.27 |
Emblem Health Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,230.27 | Professional | None | $630.96 | $812.83 | $1,230.27 |
Excellus BCBS Setting Professional Modifier None Typical Low $380.19 Median $645.65 Typical High $891.25 | Professional | None | $380.19 | $645.65 | $891.25 |
MVP Health Care Setting Facility Modifier None Typical Low $676.08 Median $3,235.94 Typical High $4,365.16 | Facility | None | $676.08 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $660.69 Median $676.08 Typical High $1,621.81 | Professional | None | $660.69 | $676.08 | $1,621.81 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,290.87 Typical High $6,760.83 | Facility | None | $851.14 | $2,290.87 | $6,760.83 |
United Setting Professional Modifier None Typical Low $467.74 Median $660.69 Typical High $1,584.89 | Professional | None | $467.74 | $660.69 | $1,584.89 |
Univera Setting Facility Modifier None Typical Low $446.68 Median $630.96 Typical High $2,630.27 | Facility | None | $446.68 | $630.96 | $2,630.27 |
Univera Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $891.25 | Professional | None | $446.68 | $630.96 | $891.25 |
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 $363.08 | Professional | 52 · Reduced service | $309.03 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $457.09 Typical High $537.03 | Professional | 54 · Surgery only | $457.09 | $457.09 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $91.20 Typical High $107.15 | Professional | 55 · Aftercare only | $91.20 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $72.44 | Professional | 56 · Pre-op care only | $61.66 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $426.58 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $426.58 | $426.58 | $501.19 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $501.19 Typical High $741.31 | Professional | 54 · Surgery only | $302.00 | $501.19 | $741.31 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $134.90 Typical High $199.53 | Professional | 55 · Aftercare only | $79.43 | $134.90 | $199.53 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $64.57 Typical High $95.50 | Professional | 56 · Pre-op care only | $38.02 | $64.57 | $95.50 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $446.68 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $263.03 | $446.68 | $645.65 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $524.81 | Professional | 53 · Discontinued | $331.13 | $338.84 | $524.81 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $501.19 Typical High $691.83 | Professional | 54 · Surgery only | $302.00 | $501.19 | $691.83 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $134.90 Typical High $354.81 | Professional | 55 · Aftercare only | $79.43 | $134.90 | $354.81 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $64.57 Typical High $169.82 | Professional | 56 · Pre-op care only | $38.02 | $64.57 | $169.82 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $446.68 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $263.03 | $446.68 | $630.96 |
Where New York sits
The same service costs 7.8 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· 45th of 51
$631
AK $2,754TX $355
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.