How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,230 to $9,772Professionalmedian $692 · 10th to 90th $550 to $1,202
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 $724.44 Median $724.44 Typical High $1,412.54 | Professional | None | $724.44 | $724.44 | $1,412.54 |
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 $660.69 Typical High $954.99 | Professional | None | $562.34 | $660.69 | $954.99 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $416.87 Typical High $588.84 | Professional | 62 · Two surgeons | $354.81 | $416.87 | $588.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $104.71 Typical High $151.36 | Professional | 80 · Assistant surgeon | $89.13 | $104.71 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $93.33 Typical High $131.83 | Professional | AS · PA/NP assist | $77.62 | $93.33 | $131.83 |
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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,318.26 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,621.81 | Professional | None | $707.95 | $707.95 | $1,621.81 |
Emblem Health Setting Facility Modifier None Typical Low $776.25 Median $1,122.02 Typical High $2,818.38 | Facility | None | $776.25 | $1,122.02 | $2,818.38 |
Emblem Health Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,230.27 | Professional | None | $660.69 | $794.33 | $1,230.27 |
Excellus BCBS Setting Professional Modifier None Typical Low $407.38 Median $645.65 Typical High $954.99 | Professional | None | $407.38 | $645.65 | $954.99 |
MVP Health Care Setting Facility Modifier None Typical Low $724.44 Median $4,786.30 Typical High $5,754.40 | Facility | None | $724.44 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,819.70 | Professional | None | $741.31 | $1,023.29 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $1,737.80 | Professional | None | $478.63 | $741.31 | $1,737.80 |
Univera Setting Facility Modifier None Typical Low $478.63 Median $660.69 Typical High $3,235.94 | Facility | None | $478.63 | $660.69 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $954.99 | Professional | None | $478.63 | $645.65 | $954.99 |
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 $363.08 Median $363.08 Typical High $371.54 | Professional | 52 · Reduced service | $363.08 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | 53 · Discontinued | $144.54 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $549.54 Typical High $562.34 | Professional | 54 · Surgery only | $549.54 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $109.65 Typical High $112.20 | Professional | 55 · Aftercare only | $109.65 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $74.13 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $512.86 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $512.86 | $512.86 | $524.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $501.19 Typical High $794.33 | Professional | 54 · Surgery only | $323.59 | $501.19 | $794.33 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $134.90 Typical High $213.80 | Professional | 55 · Aftercare only | $85.11 | $134.90 | $213.80 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $64.57 Typical High $102.33 | Professional | 56 · Pre-op care only | $40.74 | $64.57 | $102.33 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $436.52 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $281.84 | $436.52 | $691.83 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $380.19 Typical High $549.54 | Professional | 53 · Discontinued | $371.54 | $380.19 | $549.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $501.19 Typical High $741.31 | Professional | 54 · Surgery only | $323.59 | $501.19 | $741.31 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $134.90 Typical High $380.19 | Professional | 55 · Aftercare only | $85.11 | $134.90 | $380.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $64.57 Typical High $181.97 | Professional | 56 · Pre-op care only | $40.74 | $64.57 | $181.97 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $436.52 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $281.84 | $436.52 | $660.69 |
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· 46th of 51
$692
AK $2,951TX $347
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.