How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,318 to $9,772Professionalmedian $977 · 10th to 90th $794 to $1,549
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 $1,000.00 Median $1,000.00 Typical High $1,071.52 | Professional | None | $1,000.00 | $1,000.00 | $1,071.52 |
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 $831.76 Median $977.24 Typical High $1,288.25 | Professional | None | $831.76 | $977.24 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,479.11 Typical High $1,905.46 | Professional | 50 · Both sides | $1,258.93 | $1,479.11 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $158.49 Typical High $204.17 | Professional | 80 · Assistant surgeon | $134.90 | $158.49 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $138.04 Typical High $177.83 | Professional | AS · PA/NP assist | $117.49 | $138.04 | $177.83 |
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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $2,754.23 Typical High $5,623.41 | Facility | None | $1,621.81 | $2,754.23 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $2,187.76 | Professional | None | $891.25 | $891.25 | $2,187.76 |
Emblem Health Setting Facility Modifier None Typical Low $977.24 Median $1,445.44 Typical High $3,548.13 | Facility | None | $977.24 | $1,445.44 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $1,659.59 | Professional | None | $870.96 | $1,071.52 | $1,659.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $1,318.26 | Professional | None | $575.44 | $870.96 | $1,318.26 |
MVP Health Care Setting Facility Modifier None Typical Low $870.96 Median $4,786.30 Typical High $5,754.40 | Facility | None | $870.96 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,288.25 | $2,454.71 |
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 $616.60 Median $977.24 Typical High $2,290.87 | Professional | None | $616.60 | $977.24 | $2,290.87 |
Univera Setting Facility Modifier None Typical Low $676.08 Median $870.96 Typical High $3,388.44 | Facility | None | $676.08 | $870.96 | $3,388.44 |
Univera Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,318.26 | Professional | None | $676.08 | $870.96 | $1,318.26 |
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 $501.19 Median $501.19 Typical High $524.81 | Professional | 52 · Reduced service | $501.19 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $208.93 | Professional | 53 · Discontinued | $199.53 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $776.25 | Professional | 54 · Surgery only | $758.58 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $158.49 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $104.71 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $724.44 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $691.83 Typical High $1,122.02 | Professional | 54 · Surgery only | $446.68 | $691.83 | $1,122.02 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $186.21 Typical High $295.12 | Professional | 55 · Aftercare only | $120.23 | $186.21 | $295.12 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $87.10 Typical High $141.25 | Professional | 56 · Pre-op care only | $57.54 | $87.10 | $141.25 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $602.56 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $398.11 | $602.56 | $977.24 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $549.54 Typical High $776.25 | Professional | 53 · Discontinued | $524.81 | $549.54 | $776.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $691.83 Typical High $1,047.13 | Professional | 54 · Surgery only | $446.68 | $691.83 | $1,047.13 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $186.21 Typical High $537.03 | Professional | 55 · Aftercare only | $120.23 | $186.21 | $537.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $87.10 Typical High $251.19 | Professional | 56 · Pre-op care only | $57.54 | $87.10 | $251.19 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $602.56 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $398.11 | $602.56 | $912.01 |
Where New York sits
The same service costs 7.6 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· 44th of 51
$977
AK $3,981TX $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.