How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,445 to $9,772Professionalmedian $1,585 · 10th to 90th $1,288 to $2,692
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 $5,248.07 Typical High $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $3,235.94 | Professional | None | $1,548.82 | $1,548.82 | $3,235.94 |
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 $1,348.96 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,348.96 | $1,584.89 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,344.23 Typical High $3,235.94 | Professional | 50 · Both sides | $1,995.26 | $2,344.23 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $251.19 Typical High $346.74 | Professional | 80 · Assistant surgeon | $213.80 | $251.19 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $218.78 Typical High $302.00 | Professional | AS · PA/NP assist | $186.21 | $218.78 | $302.00 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $2,754.23 Typical High $5,370.32 | Facility | None | $1,412.54 | $2,754.23 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $3,715.35 | Professional | None | $1,659.59 | $1,659.59 | $3,715.35 |
Emblem Health Setting Facility Modifier None Typical Low $1,737.80 Median $2,398.83 Typical High $6,025.60 | Facility | None | $1,737.80 | $2,398.83 | $6,025.60 |
Emblem Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,548.82 | $1,819.70 | $2,818.38 |
Excellus BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $2,137.96 | Professional | None | $933.25 | $1,445.44 | $2,137.96 |
MVP Health Care Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,621.81 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $4,168.69 | Professional | None | $1,698.24 | $2,238.72 | $4,168.69 |
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 $1,096.48 Median $1,698.24 Typical High $3,981.07 | Professional | None | $1,096.48 | $1,698.24 | $3,981.07 |
Univera Setting Facility Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $7,943.28 | Facility | None | $1,096.48 | $1,548.82 | $7,943.28 |
Univera Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,445.44 | $2,137.96 |
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 $776.25 Median $776.25 Typical High $870.96 | Professional | 52 · Reduced service | $776.25 | $776.25 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | 53 · Discontinued | $309.03 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $173.78 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,230.27 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,148.15 Typical High $1,819.70 | Professional | 54 · Surgery only | $741.31 | $1,148.15 | $1,819.70 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $309.03 Typical High $478.63 | Professional | 55 · Aftercare only | $194.98 | $309.03 | $478.63 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $144.54 Typical High $229.09 | Professional | 56 · Pre-op care only | $93.33 | $144.54 | $229.09 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,000.00 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $645.65 | $1,000.00 | $1,584.89 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $851.14 Median $870.96 Typical High $1,288.25 | Professional | 53 · Discontinued | $851.14 | $870.96 | $1,288.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $1,148.15 Typical High $1,698.24 | Professional | 54 · Surgery only | $741.31 | $1,148.15 | $1,698.24 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $309.03 Typical High $870.96 | Professional | 55 · Aftercare only | $194.98 | $309.03 | $870.96 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $144.54 Typical High $416.87 | Professional | 56 · Pre-op care only | $93.33 | $144.54 | $416.87 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,000.00 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $645.65 | $1,000.00 | $1,548.82 |
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· 43rd of 51
$1,585
AK $6,761TX $871
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.