How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,413 to $11,749Professionalmedian $1,096 · 10th to 90th $871 to $1,862
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 $977.24 Median $977.24 Typical High $1,174.90 | Professional | None | $977.24 | $977.24 | $1,174.90 |
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 $933.25 Median $1,096.48 Typical High $1,513.56 | Professional | None | $933.25 | $1,096.48 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,621.81 Typical High $2,238.72 | Professional | 50 · Both sides | $1,380.38 | $1,621.81 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $173.78 Typical High $239.88 | Professional | 80 · Assistant surgeon | $147.91 | $173.78 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $208.93 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $208.93 |
CDPHP Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $7,585.78 Typical High $15,488.17 | Facility | None | $1,737.80 | $7,585.78 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $2,511.89 | Professional | None | $1,096.48 | $1,096.48 | $2,511.89 |
Emblem Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,584.89 Typical High $4,073.80 | Facility | None | $1,122.02 | $1,584.89 | $4,073.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,905.46 | Professional | None | $1,023.29 | $1,230.27 | $1,905.46 |
Excellus BCBS Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,479.11 | Professional | None | $630.96 | $977.24 | $1,479.11 |
MVP Health Care Setting Facility Modifier None Typical Low $1,096.48 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,096.48 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,445.44 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,073.80 | $14,125.38 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,148.15 Typical High $2,691.53 | Professional | None | $741.31 | $1,148.15 | $2,691.53 |
Univera Setting Facility Modifier None Typical Low $741.31 Median $1,023.29 Typical High $4,897.79 | Facility | None | $741.31 | $1,023.29 | $4,897.79 |
Univera Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,479.11 | Professional | None | $741.31 | $977.24 | $1,479.11 |
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 $489.78 Median $489.78 Typical High $588.84 | Professional | 52 · Reduced service | $489.78 | $489.78 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | 53 · Discontinued | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | 54 · Surgery only | $724.44 | $724.44 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $173.78 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $117.49 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $812.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $776.25 Typical High $1,258.93 | Professional | 54 · Surgery only | $501.19 | $776.25 | $1,258.93 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $204.17 Typical High $331.13 | Professional | 55 · Aftercare only | $134.90 | $204.17 | $331.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $97.72 Typical High $158.49 | Professional | 56 · Pre-op care only | $63.10 | $97.72 | $158.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $676.08 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $436.52 | $676.08 | $1,096.48 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $588.84 Typical High $870.96 | Professional | 53 · Discontinued | $588.84 | $588.84 | $870.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $776.25 Typical High $1,174.90 | Professional | 54 · Surgery only | $501.19 | $776.25 | $1,174.90 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $204.17 Typical High $588.84 | Professional | 55 · Aftercare only | $134.90 | $204.17 | $588.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $97.72 Typical High $281.84 | Professional | 56 · Pre-op care only | $63.10 | $97.72 | $281.84 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $676.08 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $436.52 | $676.08 | $1,023.29 |
Where New York sits
The same service costs 8.7 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
$1,096
AK $4,571TX $525
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.