How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,072 to $9,120Professionalmedian $589 · 10th to 90th $468 to $871
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 $645.65 Median $758.58 Typical High $758.58 | Professional | None | $645.65 | $758.58 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $851.14 | Professional | None | $501.19 | $588.84 | $851.14 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $371.54 Typical High $537.03 | Professional | 62 · Two surgeons | $316.23 | $371.54 | $537.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $95.50 Typical High $134.90 | Professional | 80 · Assistant surgeon | $79.43 | $95.50 | $134.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $83.18 Typical High $120.23 | Professional | AS · PA/NP assist | $70.79 | $83.18 | $120.23 |
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 $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,511.89 Typical High $5,011.87 | Facility | None | $1,348.96 | $2,511.89 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $1,202.26 | Professional | None | $457.09 | $467.74 | $1,202.26 |
Emblem Health Setting Facility Modifier None Typical Low $616.60 Median $758.58 Typical High $2,238.72 | Facility | None | $616.60 | $758.58 | $2,238.72 |
Emblem Health Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $1,096.48 | Professional | None | $549.54 | $630.96 | $1,096.48 |
Excellus BCBS Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $794.33 | Professional | None | $407.38 | $524.81 | $794.33 |
MVP Health Care Setting Facility Modifier None Typical Low $660.69 Median $4,786.30 Typical High $5,754.40 | Facility | None | $660.69 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $912.01 | Professional | None | $851.14 | $851.14 | $912.01 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $11,220.18 | Facility | None | $1,318.26 | $3,548.13 | $11,220.18 |
United Setting Professional Modifier None Typical Low $398.11 Median $562.34 Typical High $891.25 | Professional | None | $398.11 | $562.34 | $891.25 |
Univera Setting Facility Modifier None Typical Low $389.05 Median $549.54 Typical High $2,398.83 | Facility | None | $389.05 | $549.54 | $2,398.83 |
Univera Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $794.33 | Professional | None | $407.38 | $524.81 | $794.33 |
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 $316.23 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $478.63 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $524.81 | $524.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $467.74 Typical High $724.44 | Professional | 54 · Surgery only | $295.12 | $467.74 | $724.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $51.29 Typical High $81.28 | Professional | 55 · Aftercare only | $33.11 | $51.29 | $81.28 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $46.77 Typical High $72.44 | Professional | 56 · Pre-op care only | $29.51 | $46.77 | $72.44 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $416.87 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $269.15 | $416.87 | $660.69 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $407.38 Typical High $616.60 | Professional | 53 · Discontinued | $316.23 | $407.38 | $616.60 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $478.63 Typical High $724.44 | Professional | 54 · Surgery only | $295.12 | $478.63 | $724.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $52.48 Typical High $128.82 | Professional | 55 · Aftercare only | $33.11 | $52.48 | $128.82 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $47.86 Typical High $117.49 | Professional | 56 · Pre-op care only | $29.51 | $47.86 | $117.49 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $426.58 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $269.15 | $426.58 | $645.65 |
Where New York sits
The same service costs 6.5 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
$589
AK $2,455TX $380
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.