How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,148 to $8,710Professionalmedian $676 · 10th to 90th $537 to $1,413
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 $5,888.44 Typical High $10,715.19 | Facility | None | $1,819.70 | $5,888.44 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,659.59 | Professional | None | $831.76 | $831.76 | $1,659.59 |
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 $575.44 Median $676.08 Typical High $1,258.93 | Professional | None | $575.44 | $676.08 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $107.15 Typical High $199.53 | Professional | 80 · Assistant surgeon | $91.20 | $107.15 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $95.50 Typical High $173.78 | Professional | AS · PA/NP assist | $81.28 | $95.50 | $173.78 |
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 $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | None | $1,000.00 | $1,000.00 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $2,884.03 Typical High $5,888.44 | Facility | None | $1,348.96 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $2,754.23 | Professional | None | $602.56 | $758.58 | $2,754.23 |
Emblem Health Setting Facility Modifier None Typical Low $741.31 Median $1,174.90 Typical High $2,630.27 | Facility | None | $741.31 | $1,174.90 | $2,630.27 |
Emblem Health Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,288.25 | Professional | None | $676.08 | $776.25 | $1,288.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $1,023.29 | Professional | None | $478.63 | $616.60 | $1,023.29 |
MVP Health Care Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $4,786.30 | Facility | None | $776.25 | $776.25 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,023.29 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $489.78 Median $741.31 Typical High $1,905.46 | Professional | None | $489.78 | $741.31 | $1,905.46 |
Univera Setting Facility Modifier None Typical Low $407.38 Median $630.96 Typical High $2,454.71 | Facility | None | $407.38 | $630.96 | $2,454.71 |
Univera Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $1,023.29 | Professional | None | $478.63 | $616.60 | $1,023.29 |
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 $416.87 Median $416.87 Typical High $457.09 | Professional | 52 · Reduced service | $416.87 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $165.96 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $676.08 | Professional | 54 · Surgery only | $616.60 | $616.60 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $134.90 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $630.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $549.54 Typical High $1,023.29 | Professional | 54 · Surgery only | $426.58 | $549.54 | $1,023.29 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $61.66 Typical High $112.20 | Professional | 55 · Aftercare only | $47.86 | $61.66 | $112.20 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $61.66 Typical High $112.20 | Professional | 56 · Pre-op care only | $47.86 | $61.66 | $112.20 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $489.78 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $380.19 | $489.78 | $912.01 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $467.74 Typical High $707.95 | Professional | 53 · Discontinued | $363.08 | $467.74 | $707.95 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $562.34 Typical High $912.01 | Professional | 54 · Surgery only | $426.58 | $562.34 | $912.01 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $61.66 Typical High $138.04 | Professional | 55 · Aftercare only | $47.86 | $61.66 | $138.04 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $61.66 Typical High $138.04 | Professional | 56 · Pre-op care only | $47.86 | $61.66 | $138.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $501.19 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $380.19 | $501.19 | $812.83 |
Where New York sits
The same service costs 5.8 times more in Alaska than in Utah. 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· 48th of 51
$708
AK $2,818UT $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.