How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,047 to $11,482Professionalmedian $891 · 10th to 90th $676 to $1,820
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 $2,137.96 Median $6,456.54 Typical High $13,182.57 | Facility | None | $2,137.96 | $6,456.54 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $2,454.71 | Professional | None | $794.33 | $1,122.02 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,309.57 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,698.24 | Professional | None | $724.44 | $851.14 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $269.15 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $117.49 Typical High $239.88 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $239.88 |
CDPHP Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
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 $891.25 Median $1,000.00 Typical High $3,388.44 | Professional | None | $891.25 | $1,000.00 | $3,388.44 |
Emblem Health Setting Facility Modifier None Typical Low $912.01 Median $1,288.25 Typical High $3,311.31 | Facility | None | $912.01 | $1,288.25 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,659.59 | Professional | None | $812.83 | $1,047.13 | $1,659.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,288.25 | Professional | None | $616.60 | $776.25 | $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 $1,202.26 Median $1,202.26 Typical High $2,290.87 | Professional | None | $1,202.26 | $1,202.26 | $2,290.87 |
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 $676.08 Median $1,174.90 Typical High $2,398.83 | Professional | None | $676.08 | $1,174.90 | $2,398.83 |
Univera Setting Facility Modifier None Typical Low $660.69 Median $676.08 Typical High $2,818.38 | Facility | None | $660.69 | $676.08 | $2,818.38 |
Univera Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,230.27 | Professional | None | $616.60 | $776.25 | $1,230.27 |
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 $398.11 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $398.11 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $158.49 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $602.56 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $120.23 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $79.43 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $562.34 | $776.25 | $776.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $660.69 Typical High $1,148.15 | Professional | 54 · Surgery only | $524.81 | $660.69 | $1,148.15 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $107.15 Typical High $186.21 | Professional | 55 · Aftercare only | $87.10 | $107.15 | $186.21 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $93.33 Typical High $162.18 | Professional | 56 · Pre-op care only | $74.13 | $93.33 | $162.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $575.44 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $457.09 | $575.44 | $1,000.00 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $630.96 Typical High $933.25 | Professional | 53 · Discontinued | $467.74 | $630.96 | $933.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $676.08 Typical High $1,122.02 | Professional | 54 · Surgery only | $524.81 | $676.08 | $1,122.02 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $112.20 Typical High $251.19 | Professional | 55 · Aftercare only | $87.10 | $112.20 | $251.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $95.50 Typical High $213.80 | Professional | 56 · Pre-op care only | $74.13 | $95.50 | $213.80 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $588.84 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $457.09 | $588.84 | $954.99 |
Where New York sits
The same service costs 6.3 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· 45th of 51
$912
AK $3,715UT $589
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.