How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,096 to $11,220Professionalmedian $1,349 · 10th to 90th $1,072 to $2,818
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 $1,348.96 Median $1,348.96 Typical High $2,290.87 | Professional | None | $1,348.96 | $1,348.96 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,456.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,348.96 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $213.80 Typical High $426.58 | Professional | 80 · Assistant surgeon | $181.97 | $213.80 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $186.21 Typical High $371.54 | Professional | AS · PA/NP assist | $158.49 | $186.21 | $371.54 |
CDPHP Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $5,495.41 | Professional | None | $1,096.48 | $1,778.28 | $5,495.41 |
Emblem Health Setting Facility Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $5,248.07 | Facility | None | $1,621.81 | $2,041.74 | $5,248.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,754.23 | Professional | None | $1,479.11 | $1,698.24 | $2,754.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,698.24 | Professional | None | $912.01 | $1,258.93 | $1,698.24 |
MVP Health Care Setting Facility Modifier None Typical Low $1,513.56 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,513.56 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $3,548.13 | Professional | None | $1,949.84 | $2,238.72 | $3,548.13 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $4,168.69 | Professional | None | $1,071.52 | $1,513.56 | $4,168.69 |
Univera Setting Facility Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $5,128.61 | Facility | None | $1,000.00 | $1,288.25 | $5,128.61 |
Univera Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,659.59 | Professional | None | $912.01 | $1,258.93 | $1,659.59 |
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 $676.08 Median $676.08 Typical High $812.83 | Professional | 52 · Reduced service | $676.08 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $331.13 | Professional | 53 · Discontinued | $269.15 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $245.47 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $165.96 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,148.15 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,071.52 Typical High $1,584.89 | Professional | 54 · Surgery only | $794.33 | $1,071.52 | $1,584.89 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $173.78 Typical High $257.04 | Professional | 55 · Aftercare only | $128.82 | $173.78 | $257.04 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $125.89 Typical High $181.97 | Professional | 56 · Pre-op care only | $91.20 | $125.89 | $181.97 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $954.99 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $691.83 | $954.99 | $1,380.38 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $954.99 Typical High $1,380.38 | Professional | 53 · Discontinued | $707.95 | $954.99 | $1,380.38 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,071.52 Typical High $1,412.54 | Professional | 54 · Surgery only | $794.33 | $1,071.52 | $1,412.54 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $173.78 Typical High $371.54 | Professional | 55 · Aftercare only | $128.82 | $173.78 | $371.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $125.89 Typical High $269.15 | Professional | 56 · Pre-op care only | $91.20 | $125.89 | $269.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $954.99 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $691.83 | $954.99 | $1,288.25 |
Where New York sits
The same service costs 7.4 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· 42nd of 51
$1,380
AK $5,623TX $759
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.