How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,202 to $10,000Professionalmedian $708 · 10th to 90th $575 to $1,479
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 $1,737.80 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,737.80 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,148.15 | Professional | None | $870.96 | $870.96 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,318.26 | Professional | None | $602.56 | $707.95 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,071.52 Typical High $1,995.26 | Professional | 50 · Both sides | $912.01 | $1,071.52 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $114.82 Typical High $213.80 | Professional | 80 · Assistant surgeon | $97.72 | $114.82 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $100.00 Typical High $186.21 | Professional | AS · PA/NP assist | $85.11 | $100.00 | $186.21 |
CDPHP Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $10,964.78 | Facility | None | $3,630.78 | $3,630.78 | $10,964.78 |
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 $2,884.03 Typical High $5,888.44 | Facility | None | $1,445.44 | $2,884.03 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $2,884.03 | Professional | None | $645.65 | $851.14 | $2,884.03 |
Emblem Health Setting Facility Modifier None Typical Low $776.25 Median $1,071.52 Typical High $2,754.23 | Facility | None | $776.25 | $1,071.52 | $2,754.23 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $1,348.96 | Professional | None | $724.44 | $831.76 | $1,348.96 |
Excellus BCBS Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $1,071.52 | Professional | None | $501.19 | $645.65 | $1,071.52 |
MVP Health Care Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $4,786.30 | Facility | None | $794.33 | $794.33 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,819.70 | Professional | None | $1,047.13 | $1,047.13 | $1,819.70 |
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 $512.86 Median $776.25 Typical High $1,995.26 | Professional | None | $512.86 | $776.25 | $1,995.26 |
Univera Setting Facility Modifier None Typical Low $426.58 Median $660.69 Typical High $2,630.27 | Facility | None | $426.58 | $660.69 | $2,630.27 |
Univera Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $1,071.52 | Professional | None | $501.19 | $645.65 | $1,071.52 |
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 $436.52 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $436.52 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $173.78 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $724.44 | Professional | 54 · Surgery only | $660.69 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $144.54 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $676.08 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $588.84 Typical High $1,000.00 | Professional | 54 · Surgery only | $457.09 | $588.84 | $1,000.00 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $64.57 Typical High $109.65 | Professional | 55 · Aftercare only | $50.12 | $64.57 | $109.65 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $64.57 Typical High $109.65 | Professional | 56 · Pre-op care only | $50.12 | $64.57 | $109.65 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $512.86 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $407.38 | $512.86 | $891.25 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $501.19 Typical High $758.58 | Professional | 53 · Discontinued | $380.19 | $501.19 | $758.58 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $588.84 Typical High $977.24 | Professional | 54 · Surgery only | $457.09 | $588.84 | $977.24 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $66.07 Typical High $147.91 | Professional | 55 · Aftercare only | $50.12 | $66.07 | $147.91 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $66.07 Typical High $147.91 | Professional | 56 · Pre-op care only | $50.12 | $66.07 | $147.91 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $524.81 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $407.38 | $524.81 | $870.96 |
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
$759
AK $3,020UT $525
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.