How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,072 to $10,000Professionalmedian $1,445 · 10th to 90th $1,148 to $2,951
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 $1,737.80 Median $1,737.80 Typical High $2,238.72 | Professional | None | $1,737.80 | $1,737.80 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,548.82 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,691.53 | Professional | None | $1,230.27 | $1,445.44 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $234.42 Typical High $426.58 | Professional | 80 · Assistant surgeon | $199.53 | $234.42 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $204.17 Typical High $371.54 | Professional | AS · PA/NP assist | $173.78 | $204.17 | $371.54 |
CDPHP Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $1,318.26 Median $1,621.81 Typical High $5,888.44 | Professional | None | $1,318.26 | $1,621.81 | $5,888.44 |
Emblem Health Setting Facility Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $5,248.07 | Facility | None | $1,445.44 | $1,862.09 | $5,248.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,659.59 | $2,691.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,288.25 | $2,187.76 |
MVP Health Care Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $4,786.30 | Facility | None | $1,659.59 | $1,659.59 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,715.35 | Professional | None | $2,137.96 | $2,137.96 | $3,715.35 |
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 $1,023.29 Median $1,584.89 Typical High $4,073.80 | Professional | None | $1,023.29 | $1,584.89 | $4,073.80 |
Univera Setting Facility Modifier None Typical Low $870.96 Median $1,348.96 Typical High $5,623.41 | Facility | None | $870.96 | $1,348.96 | $5,623.41 |
Univera Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,288.25 | $2,137.96 |
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 $870.96 Median $870.96 Typical High $977.24 | Professional | 52 · Reduced service | $870.96 | $870.96 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $389.05 | Professional | 53 · Discontinued | $354.81 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $295.12 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $194.98 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,348.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,174.90 Typical High $1,995.26 | Professional | 54 · Surgery only | $912.01 | $1,174.90 | $1,995.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $128.82 Typical High $223.87 | Professional | 55 · Aftercare only | $102.33 | $128.82 | $223.87 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $128.82 Typical High $223.87 | Professional | 56 · Pre-op care only | $102.33 | $128.82 | $223.87 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,023.29 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $812.83 | $1,023.29 | $1,778.28 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $1,023.29 Typical High $1,513.56 | Professional | 53 · Discontinued | $776.25 | $1,023.29 | $1,513.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,202.26 Typical High $1,949.84 | Professional | 54 · Surgery only | $912.01 | $1,202.26 | $1,949.84 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $131.83 Typical High $295.12 | Professional | 55 · Aftercare only | $102.33 | $131.83 | $295.12 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $131.83 Typical High $295.12 | Professional | 56 · Pre-op care only | $102.33 | $131.83 | $295.12 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,071.52 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $812.83 | $1,071.52 | $1,737.80 |
Where New York sits
The same service costs 6.0 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· 43rd of 51
$1,549
AK $6,026TX $1,000
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.