How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,413 to $14,125Professionalmedian $1,318 · 10th to 90th $1,047 to $2,239
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 $1,348.96 Median $1,348.96 Typical High $1,479.11 | Professional | None | $1,348.96 | $1,348.96 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $199.53 Typical High $288.40 | Professional | 80 · Assistant surgeon | $169.82 | $199.53 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $177.83 Typical High $257.04 | Professional | AS · PA/NP assist | $151.36 | $177.83 | $257.04 |
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 $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $5,888.44 Typical High $12,022.64 | Facility | None | $1,778.28 | $5,888.44 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $3,162.28 | Professional | None | $1,380.38 | $1,380.38 | $3,162.28 |
Emblem Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $5,128.61 | Facility | None | $1,258.93 | $1,621.81 | $5,128.61 |
Emblem Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,548.82 | $2,570.40 |
Excellus BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,230.27 Typical High $1,819.70 | Professional | None | $776.25 | $1,230.27 | $1,819.70 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,786.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $3,467.37 | Professional | None | $1,445.44 | $1,995.26 | $3,467.37 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,162.28 | $10,471.29 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $3,388.44 | Professional | None | $933.25 | $1,412.54 | $3,388.44 |
Univera Setting Facility Modifier None Typical Low $912.01 Median $1,023.29 Typical High $7,943.28 | Facility | None | $912.01 | $1,023.29 | $7,943.28 |
Univera Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,819.70 | Professional | None | $912.01 | $1,148.15 | $1,819.70 |
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 $676.08 Median $676.08 Typical High $741.31 | Professional | 52 · Reduced service | $676.08 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $295.12 | Professional | 53 · Discontinued | $269.15 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $218.78 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $147.91 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,023.29 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $977.24 Typical High $1,513.56 | Professional | 54 · Surgery only | $616.60 | $977.24 | $1,513.56 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $263.03 Typical High $407.38 | Professional | 55 · Aftercare only | $162.18 | $263.03 | $407.38 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $123.03 Typical High $194.98 | Professional | 56 · Pre-op care only | $77.62 | $123.03 | $194.98 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $851.14 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $537.03 | $851.14 | $1,318.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $724.44 Typical High $1,071.52 | Professional | 53 · Discontinued | $707.95 | $724.44 | $1,071.52 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $977.24 Typical High $1,412.54 | Professional | 54 · Surgery only | $616.60 | $977.24 | $1,412.54 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $263.03 Typical High $724.44 | Professional | 55 · Aftercare only | $162.18 | $263.03 | $724.44 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $123.03 Typical High $346.74 | Professional | 56 · Pre-op care only | $77.62 | $123.03 | $346.74 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $851.14 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $537.03 | $851.14 | $1,258.93 |
Where New York sits
The same service costs 17.0 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
$1,318
AK $5,623TX $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.