How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,072 to $11,220Professionalmedian $1,175 · 10th to 90th $933 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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,380.38 | $1,479.11 | $1,479.11 |
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 $977.24 Median $1,148.15 Typical High $2,137.96 | Professional | None | $977.24 | $1,148.15 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,737.80 Typical High $3,235.94 | Professional | 50 · Both sides | $1,479.11 | $1,737.80 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $186.21 Typical High $346.74 | Professional | 80 · Assistant surgeon | $158.49 | $186.21 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $162.18 Typical High $302.00 | Professional | AS · PA/NP assist | $138.04 | $162.18 | $302.00 |
CDPHP Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
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 $1,047.13 Median $1,288.25 Typical High $4,677.35 | Professional | None | $1,047.13 | $1,288.25 | $4,677.35 |
Emblem Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $4,168.69 | Facility | None | $1,258.93 | $1,862.09 | $4,168.69 |
Emblem Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,318.26 | $2,187.76 |
Excellus BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,778.28 | Professional | None | $851.14 | $1,047.13 | $1,778.28 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $4,786.30 | Facility | None | $1,288.25 | $1,288.25 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,951.21 | Professional | None | $1,548.82 | $1,548.82 | $2,951.21 |
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 $870.96 Median $1,258.93 Typical High $3,311.31 | Professional | None | $870.96 | $1,258.93 | $3,311.31 |
Univera Setting Facility Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $4,365.16 | Facility | None | $1,000.00 | $1,071.52 | $4,365.16 |
Univera Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,778.28 | Professional | None | $851.14 | $1,047.13 | $1,778.28 |
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 $691.83 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $691.83 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $275.42 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,047.13 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $208.93 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $138.04 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $977.24 | $1,023.29 | $1,023.29 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $954.99 Typical High $1,737.80 | Professional | 54 · Surgery only | $776.25 | $954.99 | $1,737.80 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $93.33 Typical High $169.82 | Professional | 55 · Aftercare only | $75.86 | $93.33 | $169.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $83.18 Typical High $151.36 | Professional | 56 · Pre-op care only | $67.61 | $83.18 | $151.36 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $870.96 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $707.95 | $870.96 | $1,584.89 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $812.83 Typical High $1,230.27 | Professional | 53 · Discontinued | $616.60 | $812.83 | $1,230.27 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $954.99 Typical High $1,737.80 | Professional | 54 · Surgery only | $776.25 | $954.99 | $1,737.80 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $93.33 Typical High $213.80 | Professional | 55 · Aftercare only | $75.86 | $93.33 | $213.80 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $83.18 Typical High $190.55 | Professional | 56 · Pre-op care only | $67.61 | $83.18 | $190.55 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $870.96 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $707.95 | $870.96 | $1,584.89 |
Where New York sits
The same service costs 5.9 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· 46th of 51
$1,230
AK $4,898TX $832
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.