How much rates vary
Facilitymedian $6,166 · 10th to 90th $1,349 to $14,125Professionalmedian $1,023 · 10th to 90th $813 to $1,698
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 $1,047.13 Median $1,047.13 Typical High $1,071.52 | Professional | None | $1,047.13 | $1,047.13 | $1,071.52 |
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 $851.14 Median $1,000.00 Typical High $1,380.38 | Professional | None | $851.14 | $1,000.00 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,513.56 Typical High $2,089.30 | Professional | 50 · Both sides | $1,258.93 | $1,513.56 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $158.49 Typical High $223.87 | Professional | 80 · Assistant surgeon | $134.90 | $158.49 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $141.25 Typical High $194.98 | Professional | AS · PA/NP assist | $117.49 | $141.25 | $194.98 |
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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $8,511.38 Typical High $16,982.44 | Facility | None | $1,584.89 | $8,511.38 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,023.29 | $2,344.23 |
Emblem Health Setting Facility Modifier None Typical Low $870.96 Median $1,174.90 Typical High $3,715.35 | Facility | None | $870.96 | $1,174.90 | $3,715.35 |
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 $1,348.96 | Professional | None | $588.84 | $912.01 | $1,348.96 |
MVP Health Care Setting Facility Modifier None Typical Low $1,047.13 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,047.13 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $2,630.27 | Professional | None | $1,071.52 | $1,513.56 | $2,630.27 |
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 $691.83 Median $1,071.52 Typical High $2,511.89 | Professional | None | $691.83 | $1,071.52 | $2,511.89 |
Univera Setting Facility Modifier None Typical Low $691.83 Median $954.99 Typical High $4,073.80 | Facility | None | $691.83 | $954.99 | $4,073.80 |
Univera Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,348.96 | Professional | None | $691.83 | $912.01 | $1,348.96 |
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 $524.81 Median $524.81 Typical High $537.03 | Professional | 52 · Reduced service | $524.81 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $213.80 | Professional | 53 · Discontinued | $208.93 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $812.83 | Professional | 54 · Surgery only | $794.33 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $162.18 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $107.15 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $758.58 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $724.44 Typical High $1,071.52 | Professional | 54 · Surgery only | $467.74 | $724.44 | $1,071.52 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $190.55 Typical High $288.40 | Professional | 55 · Aftercare only | $123.03 | $190.55 | $288.40 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $91.20 Typical High $134.90 | Professional | 56 · Pre-op care only | $58.88 | $91.20 | $134.90 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $630.96 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $407.38 | $630.96 | $933.25 |
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 $1,071.52 | Professional | 54 · Surgery only | $467.74 | $724.44 | $1,071.52 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $190.55 Typical High $562.34 | Professional | 55 · Aftercare only | $123.03 | $190.55 | $562.34 |
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 7.9 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
$1,023
AK $4,266TX $537
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.