How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,259 to $9,772Professionalmedian $776 · 10th to 90th $617 to $1,349
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 $794.33 Median $794.33 Typical High $891.25 | Professional | None | $794.33 | $794.33 | $891.25 |
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 $616.60 Median $724.44 Typical High $1,202.26 | Professional | None | $616.60 | $724.44 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $457.09 Typical High $645.65 | Professional | 62 · Two surgeons | $389.05 | $457.09 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $117.49 Typical High $169.82 | Professional | 80 · Assistant surgeon | $100.00 | $117.49 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $102.33 Typical High $144.54 | Professional | AS · PA/NP assist | $87.10 | $102.33 | $144.54 |
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 $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,202.26 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,412.54 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,862.09 | Professional | None | $831.76 | $831.76 | $1,862.09 |
Emblem Health Setting Facility Modifier None Typical Low $891.25 Median $1,148.15 Typical High $3,467.37 | Facility | None | $891.25 | $1,148.15 | $3,467.37 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,479.11 | Professional | None | $794.33 | $977.24 | $1,479.11 |
Excellus BCBS Setting Professional Modifier None Typical Low $478.63 Median $776.25 Typical High $1,096.48 | Professional | None | $478.63 | $776.25 | $1,096.48 |
MVP Health Care Setting Facility Modifier None Typical Low $870.96 Median $4,786.30 Typical High $5,754.40 | Facility | None | $870.96 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $2,041.74 | Professional | None | $851.14 | $954.99 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $2,041.74 | Professional | None | $588.84 | $851.14 | $2,041.74 |
Univera Setting Facility Modifier None Typical Low $562.34 Median $794.33 Typical High $4,168.69 | Facility | None | $562.34 | $794.33 | $4,168.69 |
Univera Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,096.48 | Professional | None | $562.34 | $776.25 | $1,096.48 |
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 $398.11 Median $398.11 Typical High $446.68 | Professional | 52 · Reduced service | $398.11 | $398.11 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | 53 · Discontinued | $158.49 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $602.56 Typical High $676.08 | Professional | 54 · Surgery only | $602.56 | $602.56 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $120.23 Typical High $134.90 | Professional | 55 · Aftercare only | $120.23 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $79.43 Typical High $89.13 | Professional | 56 · Pre-op care only | $79.43 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $562.34 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $562.34 | $562.34 | $630.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $616.60 Typical High $933.25 | Professional | 54 · Surgery only | $380.19 | $616.60 | $933.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $165.96 Typical High $245.47 | Professional | 55 · Aftercare only | $100.00 | $165.96 | $245.47 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $77.62 Typical High $117.49 | Professional | 56 · Pre-op care only | $47.86 | $77.62 | $117.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $537.03 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $331.13 | $537.03 | $812.83 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $630.96 | Professional | 53 · Discontinued | $426.58 | $426.58 | $630.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $616.60 Typical High $870.96 | Professional | 54 · Surgery only | $380.19 | $616.60 | $870.96 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $165.96 Typical High $446.68 | Professional | 55 · Aftercare only | $100.00 | $165.96 | $446.68 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $77.62 Typical High $213.80 | Professional | 56 · Pre-op care only | $47.86 | $77.62 | $213.80 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $537.03 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $331.13 | $537.03 | $794.33 |
Where New York sits
The same service costs 7.4 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
$776
AK $3,467TX $468
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.