How much rates vary
Facilitymedian $4,571 · 10th to 90th $871 to $10,715Professionalmedian $324 · 10th to 90th $257 to $724
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 $5,248.07 Typical High $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $891.25 | Professional | None | $295.12 | $407.38 | $891.25 |
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 $263.03 Median $309.03 Typical High $616.60 | Professional | None | $263.03 | $309.03 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $41.69 Median $48.98 Typical High $100.00 | Professional | 80 · Assistant surgeon | $41.69 | $48.98 | $100.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $42.66 Typical High $85.11 | Professional | AS · PA/NP assist | $36.31 | $42.66 | $85.11 |
CDPHP Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,778.28 Typical High $2,754.23 | Facility | None | $794.33 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $1,230.27 | Professional | None | $323.59 | $436.52 | $1,230.27 |
Emblem Health Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $1,258.93 | Facility | None | $323.59 | $524.81 | $1,258.93 |
Emblem Health Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $616.60 | Professional | None | $331.13 | $380.19 | $616.60 |
Excellus BCBS Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $478.63 | Professional | None | $229.09 | $309.03 | $478.63 |
MVP Health Care Setting Facility Modifier None Typical Low $537.03 Median $3,235.94 Typical High $4,365.16 | Facility | None | $537.03 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $831.76 | Professional | None | $467.74 | $724.44 | $831.76 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,949.84 Typical High $6,309.57 | Facility | None | $758.58 | $1,949.84 | $6,309.57 |
United Setting Professional Modifier None Typical Low $251.19 Median $426.58 Typical High $870.96 | Professional | None | $251.19 | $426.58 | $870.96 |
Univera Setting Facility Modifier None Typical Low $245.47 Median $309.03 Typical High $1,202.26 | Facility | None | $245.47 | $309.03 | $1,202.26 |
Univera Setting Professional Modifier None Typical Low $229.09 Median $309.03 Typical High $436.52 | Professional | None | $229.09 | $309.03 | $436.52 |
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 $147.91 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $147.91 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $58.88 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $302.00 Typical High $302.00 | Professional | 54 · Surgery only | $218.78 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $44.67 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $29.51 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $281.84 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $204.17 | $281.84 | $281.84 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $245.47 Typical High $426.58 | Professional | 54 · Surgery only | $194.98 | $245.47 | $426.58 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $40.74 Typical High $69.18 | Professional | 55 · Aftercare only | $31.62 | $40.74 | $69.18 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $34.67 Typical High $58.88 | Professional | 56 · Pre-op care only | $27.54 | $34.67 | $58.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $213.80 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $169.82 | $213.80 | $363.08 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $229.09 Typical High $346.74 | Professional | 53 · Discontinued | $169.82 | $229.09 | $346.74 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $251.19 Typical High $416.87 | Professional | 54 · Surgery only | $194.98 | $251.19 | $416.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $41.69 Typical High $93.33 | Professional | 55 · Aftercare only | $31.62 | $41.69 | $93.33 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $35.48 Typical High $79.43 | Professional | 56 · Pre-op care only | $27.54 | $35.48 | $79.43 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $218.78 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $169.82 | $218.78 | $354.81 |
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
$339
AK $1,380UT $240
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.