How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,318 to $11,482Professionalmedian $1,072 · 10th to 90th $851 to $2,344
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,174.90 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,047.13 Typical High $2,137.96 | Professional | None | $870.96 | $1,047.13 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,548.82 Typical High $3,235.94 | Professional | 50 · Both sides | $1,318.26 | $1,548.82 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $165.96 Typical High $338.84 | Professional | 80 · Assistant surgeon | $141.25 | $165.96 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $144.54 Typical High $302.00 | Professional | AS · PA/NP assist | $123.03 | $144.54 | $302.00 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,513.56 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,513.56 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $4,265.80 | Professional | None | $891.25 | $1,148.15 | $4,265.80 |
Emblem Health Setting Facility Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $4,168.69 | Facility | None | $1,023.29 | $1,288.25 | $4,168.69 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $2,137.96 | Professional | None | $1,148.15 | $1,318.26 | $2,137.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,479.11 | Professional | None | $794.33 | $1,000.00 | $1,479.11 |
MVP Health Care Setting Facility Modifier None Typical Low $1,148.15 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,148.15 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,230.27 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,174.90 Typical High $3,162.28 | Professional | None | $851.14 | $1,174.90 | $3,162.28 |
Univera Setting Facility Modifier None Typical Low $851.14 Median $1,071.52 Typical High $3,630.78 | Facility | None | $851.14 | $1,071.52 | $3,630.78 |
Univera Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,445.44 | Professional | None | $794.33 | $1,000.00 | $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 $588.84 Median $588.84 Typical High $707.95 | Professional | 52 · Reduced service | $588.84 | $588.84 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | 53 · Discontinued | $239.88 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $213.80 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $141.25 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,000.00 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $870.96 Typical High $1,380.38 | Professional | 54 · Surgery only | $676.08 | $870.96 | $1,380.38 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $141.25 Typical High $223.87 | Professional | 55 · Aftercare only | $109.65 | $141.25 | $223.87 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $100.00 Typical High $158.49 | Professional | 56 · Pre-op care only | $79.43 | $100.00 | $158.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $776.25 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $602.56 | $776.25 | $1,202.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $758.58 Typical High $1,202.26 | Professional | 53 · Discontinued | $575.44 | $758.58 | $1,202.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $870.96 Typical High $1,288.25 | Professional | 54 · Surgery only | $676.08 | $870.96 | $1,288.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $141.25 Typical High $323.59 | Professional | 55 · Aftercare only | $109.65 | $141.25 | $323.59 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $102.33 Typical High $229.09 | Professional | 56 · Pre-op care only | $79.43 | $102.33 | $229.09 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $776.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $602.56 | $776.25 | $1,122.02 |
Where New York sits
The same service costs 6.9 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· 47th of 51
$1,096
AK $4,786TX $692
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.