How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,413 to $14,454Professionalmedian $1,047 · 10th to 90th $832 to $1,778
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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,148.15 | Professional | None | $933.25 | $933.25 | $1,148.15 |
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 $891.25 Median $1,047.13 Typical High $1,412.54 | Professional | None | $891.25 | $1,047.13 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,584.89 Typical High $2,089.30 | Professional | 50 · Both sides | $1,348.96 | $1,584.89 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $162.18 Typical High $257.04 | Professional | 80 · Assistant surgeon | $141.25 | $162.18 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $147.91 Typical High $194.98 | Professional | AS · PA/NP assist | $125.89 | $147.91 | $194.98 |
CDPHP Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $10,964.78 | Facility | None | $3,630.78 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $2,454.71 | Professional | None | $1,096.48 | $1,096.48 | $2,454.71 |
Emblem Health Setting Facility Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $3,981.07 | Facility | None | $1,000.00 | $1,258.93 | $3,981.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,230.27 | $1,862.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,445.44 | Professional | None | $630.96 | $977.24 | $1,445.44 |
MVP Health Care Setting Facility Modifier None Typical Low $1,000.00 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,000.00 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,754.23 | Professional | None | $1,148.15 | $1,445.44 | $2,754.23 |
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 $1,122.02 Typical High $2,691.53 | Professional | None | $741.31 | $1,122.02 | $2,691.53 |
Univera Setting Facility Modifier None Typical Low $741.31 Median $1,023.29 Typical High $4,365.16 | Facility | None | $741.31 | $1,023.29 | $4,365.16 |
Univera Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,445.44 | Professional | None | $741.31 | $977.24 | $1,445.44 |
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 $467.74 Median $467.74 Typical High $575.44 | Professional | 52 · Reduced service | $467.74 | $467.74 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $229.09 | Professional | 53 · Discontinued | $186.21 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $851.14 | Professional | 54 · Surgery only | $707.95 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $114.82 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $794.33 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $776.25 Typical High $1,148.15 | Professional | 54 · Surgery only | $489.78 | $776.25 | $1,148.15 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $204.17 Typical High $302.00 | Professional | 55 · Aftercare only | $131.83 | $204.17 | $302.00 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $97.72 Typical High $144.54 | Professional | 56 · Pre-op care only | $63.10 | $97.72 | $144.54 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $676.08 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $426.58 | $676.08 | $1,000.00 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $851.14 | Professional | 53 · Discontinued | $575.44 | $575.44 | $851.14 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $776.25 Typical High $1,148.15 | Professional | 54 · Surgery only | $489.78 | $776.25 | $1,148.15 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $204.17 Typical High $602.56 | Professional | 55 · Aftercare only | $131.83 | $204.17 | $602.56 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $97.72 Typical High $288.40 | Professional | 56 · Pre-op care only | $63.10 | $97.72 | $288.40 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $676.08 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $426.58 | $676.08 | $1,023.29 |
Where New York sits
The same service costs 13.8 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
$1,047
AK $4,467TX $324
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.