How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,349 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 $1,905.46 Median $6,165.95 Typical High $11,748.98 | Facility | None | $1,905.46 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $2,511.89 | Professional | None | $794.33 | $1,148.15 | $2,511.89 |
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 $707.95 Median $831.76 Typical High $1,698.24 | Professional | None | $707.95 | $831.76 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,258.93 Typical High $2,511.89 | Professional | 50 · Both sides | $1,071.52 | $1,258.93 | $2,511.89 |
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 $234.42 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $234.42 |
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 $870.96 Median $1,000.00 Typical High $3,311.31 | Professional | None | $870.96 | $1,000.00 | $3,311.31 |
Emblem Health Setting Facility Modifier None Typical Low $954.99 Median $1,737.80 Typical High $3,548.13 | Facility | None | $954.99 | $1,737.80 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,621.81 | Professional | None | $954.99 | $1,023.29 | $1,621.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,318.26 | Professional | None | $616.60 | $758.58 | $1,318.26 |
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 $1,174.90 Median $1,174.90 Typical High $2,290.87 | Professional | None | $1,174.90 | $1,174.90 | $2,290.87 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,090.30 Typical High $9,332.54 | Facility | None | $1,230.27 | $3,090.30 | $9,332.54 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,148.15 Typical High $2,398.83 | Professional | None | $660.69 | $1,148.15 | $2,398.83 |
Univera Setting Facility Modifier None Typical Low $660.69 Median $1,047.13 Typical High $3,162.28 | Facility | None | $660.69 | $1,047.13 | $3,162.28 |
Univera Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,258.93 | Professional | None | $562.34 | $758.58 | $1,258.93 |
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 $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $398.11 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $158.49 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $588.84 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $120.23 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $79.43 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $549.54 | $812.83 | $812.83 |
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 $85.11 Median $107.15 Typical High $186.21 | Professional | 55 · Aftercare only | $85.11 | $107.15 | $186.21 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $91.20 Typical High $158.49 | Professional | 56 · Pre-op care only | $72.44 | $91.20 | $158.49 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $562.34 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $446.68 | $562.34 | $977.24 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $616.60 Typical High $912.01 | Professional | 53 · Discontinued | $467.74 | $616.60 | $912.01 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $660.69 Typical High $1,023.29 | Professional | 54 · Surgery only | $478.63 | $660.69 | $1,023.29 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $107.15 Typical High $165.96 | Professional | 55 · Aftercare only | $79.43 | $107.15 | $165.96 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $91.20 Typical High $141.25 | Professional | 56 · Pre-op care only | $67.61 | $91.20 | $141.25 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $562.34 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $416.87 | $562.34 | $870.96 |
Where New York sits
The same service costs 6.5 times more in Alaska than in Texas. 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
$933
AK $3,715TX $575
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.