How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,023 to $7,762Professionalmedian $372 · 10th to 90th $295 to $955
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $1,174.90 | Professional | None | $380.19 | $588.84 | $1,174.90 |
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 $295.12 Median $346.74 Typical High $794.33 | Professional | None | $295.12 | $346.74 | $794.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $186.21 Median $218.78 Typical High $501.19 | Professional | 62 · Two surgeons | $186.21 | $218.78 | $501.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $56.23 Typical High $128.82 | Professional | 80 · Assistant surgeon | $47.86 | $56.23 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $48.98 Typical High $112.20 | Professional | AS · PA/NP assist | $41.69 | $48.98 | $112.20 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | None | $616.60 | $616.60 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $2,884.03 Typical High $5,754.40 | Facility | None | $1,318.26 | $2,884.03 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $1,621.81 | Professional | None | $426.58 | $562.34 | $1,621.81 |
Emblem Health Setting Facility Modifier None Typical Low $457.09 Median $870.96 Typical High $1,778.28 | Facility | None | $457.09 | $870.96 | $1,778.28 |
Emblem Health Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $794.33 | Professional | None | $426.58 | $478.63 | $794.33 |
Excellus BCBS Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $616.60 | Professional | None | $295.12 | $371.54 | $616.60 |
MVP Health Care Setting Facility Modifier None Typical Low $426.58 Median $3,235.94 Typical High $4,365.16 | Facility | None | $426.58 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $602.56 Median $954.99 Typical High $1,071.52 | Professional | None | $602.56 | $954.99 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $323.59 Median $549.54 Typical High $1,148.15 | Professional | None | $323.59 | $549.54 | $1,148.15 |
Univera Setting Facility Modifier None Typical Low $316.23 Median $398.11 Typical High $1,621.81 | Facility | None | $316.23 | $398.11 | $1,621.81 |
Univera Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $575.44 | Professional | None | $295.12 | $371.54 | $575.44 |
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 $190.55 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $190.55 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $75.86 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $288.40 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $57.54 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.02 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $269.15 | $407.38 | $407.38 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $316.23 Typical High $549.54 | Professional | 54 · Surgery only | $251.19 | $316.23 | $549.54 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $52.48 Typical High $89.13 | Professional | 55 · Aftercare only | $41.69 | $52.48 | $89.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $44.67 Typical High $77.62 | Professional | 56 · Pre-op care only | $35.48 | $44.67 | $77.62 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $275.42 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $218.78 | $275.42 | $478.63 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $288.40 Typical High $446.68 | Professional | 53 · Discontinued | $218.78 | $288.40 | $446.68 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $331.13 Typical High $537.03 | Professional | 54 · Surgery only | $251.19 | $331.13 | $537.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $53.70 Typical High $120.23 | Professional | 55 · Aftercare only | $41.69 | $53.70 | $120.23 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $45.71 Typical High $102.33 | Professional | 56 · Pre-op care only | $35.48 | $45.71 | $102.33 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $281.84 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $218.78 | $281.84 | $457.09 |
Where New York sits
The same service costs 7.1 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
$389
AK $2,042UT $288
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.