How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,288 to $11,749Professionalmedian $692 · 10th to 90th $562 to $1,047
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 $6,309.57 Typical High $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | None | $776.25 | $851.14 | $851.14 |
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 $588.84 Median $691.83 Typical High $1,023.29 | Professional | None | $588.84 | $691.83 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $109.65 Typical High $165.96 | Professional | 80 · Assistant surgeon | $93.33 | $109.65 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $95.50 Typical High $144.54 | Professional | AS · PA/NP assist | $81.28 | $95.50 | $144.54 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,445.44 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $575.44 Typical High $1,412.54 | Professional | None | $562.34 | $575.44 | $1,412.54 |
Emblem Health Setting Facility Modifier None Typical Low $478.63 Median $812.83 Typical High $2,691.53 | Facility | None | $478.63 | $812.83 | $2,691.53 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,412.54 | Professional | None | $676.08 | $812.83 | $1,412.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $977.24 | Professional | None | $501.19 | $660.69 | $977.24 |
MVP Health Care Setting Facility Modifier None Typical Low $812.83 Median $5,754.40 Typical High $23,442.29 | Facility | None | $812.83 | $5,754.40 | $23,442.29 |
MVP Health Care Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,096.48 | Professional | None | $724.44 | $724.44 | $1,096.48 |
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 $501.19 Median $660.69 Typical High $1,071.52 | Professional | None | $501.19 | $660.69 | $1,071.52 |
Univera Setting Facility Modifier None Typical Low $478.63 Median $676.08 Typical High $2,818.38 | Facility | None | $478.63 | $676.08 | $2,818.38 |
Univera Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $977.24 | Professional | None | $501.19 | $660.69 | $977.24 |
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 $389.05 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $389.05 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $154.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $588.84 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $77.62 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $602.56 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $588.84 Typical High $891.25 | Professional | 54 · Surgery only | $363.08 | $588.84 | $891.25 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $66.07 Typical High $97.72 | Professional | 55 · Aftercare only | $40.74 | $66.07 | $97.72 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $58.88 Typical High $89.13 | Professional | 56 · Pre-op care only | $36.31 | $58.88 | $89.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $537.03 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $331.13 | $537.03 | $794.33 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $489.78 Typical High $741.31 | Professional | 53 · Discontinued | $371.54 | $489.78 | $741.31 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $588.84 Typical High $891.25 | Professional | 54 · Surgery only | $363.08 | $588.84 | $891.25 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $66.07 Typical High $158.49 | Professional | 55 · Aftercare only | $40.74 | $66.07 | $158.49 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $58.88 Typical High $141.25 | Professional | 56 · Pre-op care only | $36.31 | $58.88 | $141.25 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $537.03 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $331.13 | $537.03 | $794.33 |
Where New York sits
The same service costs 6.2 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 $3,020TX $490
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.