How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,175 to $9,550Professionalmedian $692 · 10th to 90th $537 to $1,148
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 $691.83 Median $691.83 Typical High $776.25 | Professional | None | $691.83 | $691.83 | $776.25 |
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 $562.34 Median $676.08 Typical High $933.25 | Professional | None | $562.34 | $676.08 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,000.00 Typical High $1,380.38 | Professional | 50 · Both sides | $851.14 | $1,000.00 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $107.15 Typical High $147.91 | Professional | 80 · Assistant surgeon | $91.20 | $107.15 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $93.33 Typical High $128.82 | Professional | AS · PA/NP assist | $79.43 | $93.33 | $128.82 |
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 $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $6,918.31 | Facility | None | $1,318.26 | $3,548.13 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $1,513.56 | Professional | None | $691.83 | $691.83 | $1,513.56 |
Emblem Health Setting Facility Modifier None Typical Low $741.31 Median $1,023.29 Typical High $2,754.23 | Facility | None | $741.31 | $1,023.29 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $645.65 Median $776.25 Typical High $1,202.26 | Professional | None | $645.65 | $776.25 | $1,202.26 |
Excellus BCBS Setting Professional Modifier None Typical Low $398.11 Median $630.96 Typical High $912.01 | Professional | None | $398.11 | $630.96 | $912.01 |
Highmark BCBS Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
MVP Health Care Setting Facility Modifier None Typical Low $645.65 Median $4,786.30 Typical High $5,754.40 | Facility | None | $645.65 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $724.44 Median $1,000.00 Typical High $1,778.28 | Professional | None | $724.44 | $1,000.00 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $1,698.24 | Professional | None | $467.74 | $724.44 | $1,698.24 |
Univera Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $2,754.23 | Facility | None | $467.74 | $645.65 | $2,754.23 |
Univera Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $912.01 | Professional | None | $467.74 | $630.96 | $912.01 |
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 $338.84 Median $338.84 Typical High $363.08 | Professional | 52 · Reduced service | $338.84 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $138.04 Typical High $144.54 | Professional | 53 · Discontinued | $138.04 | $138.04 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $549.54 | Professional | 54 · Surgery only | $512.86 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $512.86 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $489.78 Typical High $776.25 | Professional | 54 · Surgery only | $316.23 | $489.78 | $776.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $131.83 Typical High $208.93 | Professional | 55 · Aftercare only | $83.18 | $131.83 | $208.93 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $63.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $39.81 | $63.10 | $97.72 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $426.58 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $275.42 | $426.58 | $676.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $371.54 Typical High $537.03 | Professional | 53 · Discontinued | $363.08 | $371.54 | $537.03 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $489.78 Typical High $724.44 | Professional | 54 · Surgery only | $316.23 | $489.78 | $724.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $131.83 Typical High $371.54 | Professional | 55 · Aftercare only | $83.18 | $131.83 | $371.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $63.10 Typical High $177.83 | Professional | 56 · Pre-op care only | $39.81 | $63.10 | $177.83 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $426.58 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $275.42 | $426.58 | $645.65 |
Where New York sits
The same service costs 8.5 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
$692
AK $2,884TX $339
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.