How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,259 to $9,772Professionalmedian $1,479 · 10th to 90th $1,148 to $2,512
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 $1,905.46 Median $6,165.95 Typical High $11,748.98 | Facility | None | $1,905.46 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,479.11 | $1,479.11 | $1,621.81 |
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 $1,230.27 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,230.27 | $1,445.44 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,187.76 Typical High $3,019.95 | Professional | 50 · Both sides | $1,862.09 | $2,187.76 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $229.09 Typical High $323.59 | Professional | 80 · Assistant surgeon | $194.98 | $229.09 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $204.17 Typical High $281.84 | Professional | AS · PA/NP assist | $173.78 | $204.17 | $281.84 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,584.89 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $3,311.31 | Professional | None | $1,548.82 | $1,548.82 | $3,311.31 |
Emblem Health Setting Facility Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $5,623.41 | Facility | None | $1,584.89 | $2,041.74 | $5,623.41 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,884.03 | Professional | None | $1,737.80 | $1,737.80 | $2,884.03 |
Excellus BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,380.38 Typical High $1,995.26 | Professional | None | $870.96 | $1,380.38 | $1,995.26 |
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 $1,584.89 Median $1,905.46 Typical High $3,890.45 | Professional | None | $1,584.89 | $1,905.46 | $3,890.45 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,760.83 | Facility | None | $831.76 | $2,290.87 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,584.89 Typical High $3,715.35 | Professional | None | $1,000.00 | $1,584.89 | $3,715.35 |
Univera Setting Facility Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $8,709.64 | Facility | None | $1,023.29 | $1,148.15 | $8,709.64 |
Univera Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,995.26 | Professional | None | $1,023.29 | $1,288.25 | $1,995.26 |
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 $741.31 Median $741.31 Typical High $812.83 | Professional | 52 · Reduced service | $741.31 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $323.59 | Professional | 53 · Discontinued | $295.12 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $245.47 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $162.18 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,047.13 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,047.13 | $1,148.15 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,096.48 Typical High $1,584.89 | Professional | 54 · Surgery only | $691.83 | $1,096.48 | $1,584.89 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $288.40 Typical High $426.58 | Professional | 55 · Aftercare only | $181.97 | $288.40 | $426.58 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $138.04 Typical High $199.53 | Professional | 56 · Pre-op care only | $87.10 | $138.04 | $199.53 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $954.99 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $602.56 | $954.99 | $1,380.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $812.83 Typical High $1,174.90 | Professional | 53 · Discontinued | $794.33 | $812.83 | $1,174.90 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $1,096.48 Typical High $1,584.89 | Professional | 54 · Surgery only | $691.83 | $1,096.48 | $1,584.89 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $288.40 Typical High $831.76 | Professional | 55 · Aftercare only | $181.97 | $288.40 | $831.76 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $138.04 Typical High $398.11 | Professional | 56 · Pre-op care only | $87.10 | $138.04 | $398.11 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $954.99 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $602.56 | $954.99 | $1,380.38 |
Where New York sits
The same service costs 15.8 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· 42nd of 51
$1,479
AK $6,310TX $398
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.