How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,096 to $9,333Professionalmedian $759 · 10th to 90th $617 to $1,288
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 $758.58 Median $758.58 Typical High $870.96 | Professional | None | $758.58 | $758.58 | $870.96 |
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 $1,047.13 | Professional | None | $616.60 | $724.44 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $117.49 Typical High $162.18 | Professional | 80 · Assistant surgeon | $100.00 | $117.49 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $102.33 Typical High $141.25 | Professional | AS · PA/NP assist | $87.10 | $102.33 | $141.25 |
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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,754.23 Typical High $5,370.32 | Facility | None | $1,348.96 | $2,754.23 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,778.28 | Professional | None | $812.83 | $812.83 | $1,778.28 |
Emblem Health Setting Facility Modifier None Typical Low $851.14 Median $1,148.15 Typical High $3,311.31 | Facility | None | $851.14 | $1,148.15 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,412.54 | Professional | None | $758.58 | $954.99 | $1,412.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $467.74 Median $758.58 Typical High $1,071.52 | Professional | None | $467.74 | $758.58 | $1,071.52 |
MVP Health Care Setting Facility Modifier None Typical Low $758.58 Median $4,786.30 Typical High $5,754.40 | Facility | None | $758.58 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,995.26 | Professional | None | $812.83 | $977.24 | $1,995.26 |
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 $549.54 Median $812.83 Typical High $1,905.46 | Professional | None | $549.54 | $812.83 | $1,905.46 |
Univera Setting Facility Modifier None Typical Low $549.54 Median $758.58 Typical High $3,019.95 | Facility | None | $549.54 | $758.58 | $3,019.95 |
Univera Setting Professional Modifier None Typical Low $549.54 Median $758.58 Typical High $1,071.52 | Professional | None | $549.54 | $758.58 | $1,071.52 |
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 $380.19 Median $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $380.19 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 53 · Discontinued | $151.36 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $602.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $588.84 Typical High $851.14 | Professional | 54 · Surgery only | $363.08 | $588.84 | $851.14 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $158.49 Typical High $223.87 | Professional | 55 · Aftercare only | $97.72 | $158.49 | $223.87 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $75.86 Typical High $107.15 | Professional | 56 · Pre-op care only | $46.77 | $75.86 | $107.15 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $524.81 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $323.59 | $524.81 | $741.31 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $416.87 Typical High $602.56 | Professional | 53 · Discontinued | $407.38 | $416.87 | $602.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $588.84 Typical High $851.14 | Professional | 54 · Surgery only | $363.08 | $588.84 | $851.14 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $158.49 Typical High $446.68 | Professional | 55 · Aftercare only | $97.72 | $158.49 | $446.68 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $75.86 Typical High $213.80 | Professional | 56 · Pre-op care only | $46.77 | $75.86 | $213.80 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $524.81 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $323.59 | $524.81 | $758.58 |
Where New York sits
The same service costs 8.3 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· 45th of 51
$759
AK $3,388TX $407
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.