How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,175 to $9,772Professionalmedian $1,000 · 10th to 90th $794 to $1,738
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 $6,165.95 Typical High $11,748.98 | Facility | None | $1,819.70 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $2,089.30 | Professional | None | $933.25 | $933.25 | $2,089.30 |
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 $851.14 Median $1,000.00 Typical High $1,348.96 | Professional | None | $851.14 | $1,000.00 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $158.49 Typical High $218.78 | Professional | 80 · Assistant surgeon | $134.90 | $158.49 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $141.25 Typical High $190.55 | Professional | AS · PA/NP assist | $120.23 | $141.25 | $190.55 |
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 $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
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 $1,023.29 Median $1,023.29 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,023.29 | $2,398.83 |
Emblem Health Setting Facility Modifier None Typical Low $870.96 Median $1,202.26 Typical High $3,801.89 | Facility | None | $870.96 | $1,202.26 | $3,801.89 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,778.28 | Professional | None | $954.99 | $1,148.15 | $1,778.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $588.84 Median $912.01 Typical High $1,380.38 | Professional | None | $588.84 | $912.01 | $1,380.38 |
MVP Health Care Setting Facility Modifier None Typical Low $977.24 Median $4,786.30 Typical High $5,754.40 | Facility | None | $977.24 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $2,630.27 | Professional | None | $501.19 | $501.19 | $2,630.27 |
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 $660.69 Median $1,071.52 Typical High $2,344.23 | Professional | None | $660.69 | $1,071.52 | $2,344.23 |
Univera Setting Facility Modifier None Typical Low $707.95 Median $954.99 Typical High $2,691.53 | Facility | None | $707.95 | $954.99 | $2,691.53 |
Univera Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,380.38 | Professional | None | $707.95 | $912.01 | $1,380.38 |
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 $457.09 Median $457.09 Typical High $549.54 | Professional | 52 · Reduced service | $457.09 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $218.78 | Professional | 53 · Discontinued | $186.21 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $812.83 | Professional | 54 · Surgery only | $691.83 | $691.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $162.18 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $758.58 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $724.44 Typical High $1,096.48 | Professional | 54 · Surgery only | $467.74 | $724.44 | $1,096.48 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $194.98 Typical High $288.40 | Professional | 55 · Aftercare only | $125.89 | $194.98 | $288.40 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $91.20 Typical High $138.04 | Professional | 56 · Pre-op care only | $58.88 | $91.20 | $138.04 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $630.96 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $407.38 | $630.96 | $954.99 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $549.54 Typical High $812.83 | Professional | 53 · Discontinued | $537.03 | $549.54 | $812.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $724.44 Typical High $1,096.48 | Professional | 54 · Surgery only | $467.74 | $724.44 | $1,096.48 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $194.98 Typical High $575.44 | Professional | 55 · Aftercare only | $125.89 | $194.98 | $575.44 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $91.20 Typical High $269.15 | Professional | 56 · Pre-op care only | $58.88 | $91.20 | $269.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $630.96 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $407.38 | $630.96 | $954.99 |
Where New York sits
The same service costs 7.6 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
$1,000
AK $4,266TX $562
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.