How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,175 to $7,943Professionalmedian $724 · 10th to 90th $575 to $1,622
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 $1,000.00 Median $1,000.00 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,000.00 | $2,137.96 |
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 $588.84 Median $691.83 Typical High $1,412.54 | Professional | None | $588.84 | $691.83 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $112.20 Typical High $229.09 | Professional | 80 · Assistant surgeon | $95.50 | $112.20 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $97.72 Typical High $199.53 | Professional | AS · PA/NP assist | $83.18 | $97.72 | $199.53 |
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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $3,467.37 | Facility | None | $1,230.27 | $1,905.46 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $3,162.28 | Professional | None | $691.83 | $851.14 | $3,162.28 |
Emblem Health Setting Facility Modifier None Typical Low $851.14 Median $1,348.96 Typical High $2,951.21 | Facility | None | $851.14 | $1,348.96 | $2,951.21 |
Emblem Health Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,445.44 | Professional | None | $851.14 | $933.25 | $1,445.44 |
Excellus BCBS Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $1,288.25 | Professional | None | $537.03 | $691.83 | $1,288.25 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Facility | None | $4,786.30 | $4,786.30 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $1,995.26 | Professional | None | $1,122.02 | $1,148.15 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,754.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $2,187.76 | Professional | None | $549.54 | $831.76 | $2,187.76 |
Univera Setting Facility Modifier None Typical Low $457.09 Median $933.25 Typical High $2,818.38 | Facility | None | $457.09 | $933.25 | $2,818.38 |
Univera Setting Professional Modifier None Typical Low $446.68 Median $691.83 Typical High $1,148.15 | Professional | None | $446.68 | $691.83 | $1,148.15 |
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 $501.19 Median $501.19 Typical High $512.86 | Professional | 52 · Reduced service | $501.19 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $208.93 | Professional | 53 · Discontinued | $199.53 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $776.25 | Professional | 54 · Surgery only | $741.31 | $741.31 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $154.88 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $104.71 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $724.44 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $630.96 Typical High $1,174.90 | Professional | 54 · Surgery only | $489.78 | $630.96 | $1,174.90 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $69.18 Typical High $128.82 | Professional | 55 · Aftercare only | $53.70 | $69.18 | $128.82 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $69.18 Typical High $128.82 | Professional | 56 · Pre-op care only | $53.70 | $69.18 | $128.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $562.34 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $436.52 | $562.34 | $1,023.29 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $537.03 Typical High $812.83 | Professional | 53 · Discontinued | $407.38 | $537.03 | $812.83 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $630.96 Typical High $1,047.13 | Professional | 54 · Surgery only | $407.38 | $630.96 | $1,047.13 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $69.18 Typical High $114.82 | Professional | 55 · Aftercare only | $44.67 | $69.18 | $114.82 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $69.18 Typical High $114.82 | Professional | 56 · Pre-op care only | $44.67 | $69.18 | $114.82 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $562.34 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $363.08 | $562.34 | $933.25 |
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· 49th of 51
$759
AK $3,236UT $562
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.