How much rates vary
Facilitymedian $3,236 · 10th to 90th $871 to $7,586Professionalmedian $339 · 10th to 90th $269 to $589
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 $10,471.29 | Facility | None | $1,819.70 | $5,248.07 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $467.74 | Professional | None | $380.19 | $467.74 | $467.74 |
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 $288.40 Median $338.84 Typical High $446.68 | Professional | None | $288.40 | $338.84 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $501.19 Typical High $676.08 | Professional | 50 · Both sides | $426.58 | $501.19 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $45.71 Median $53.70 Typical High $70.79 | Professional | 80 · Assistant surgeon | $45.71 | $53.70 | $70.79 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $39.81 Median $46.77 Typical High $63.10 | Professional | AS · PA/NP assist | $39.81 | $46.77 | $63.10 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
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 $1,096.48 Median $1,621.81 Typical High $3,235.94 | Facility | None | $1,096.48 | $1,621.81 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $281.84 Typical High $831.76 | Professional | None | $275.42 | $281.84 | $831.76 |
Emblem Health Setting Facility Modifier None Typical Low $354.81 Median $691.83 Typical High $1,348.96 | Facility | None | $354.81 | $691.83 | $1,348.96 |
Emblem Health Setting Professional Modifier None Typical Low $295.12 Median $363.08 Typical High $562.34 | Professional | None | $295.12 | $363.08 | $562.34 |
Excellus BCBS Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $416.87 | Professional | None | $251.19 | $295.12 | $416.87 |
MVP Health Care Setting Facility Modifier None Typical Low $380.19 Median $4,365.16 Typical High $36,307.81 | Facility | None | $380.19 | $4,365.16 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $363.08 Median $457.09 Typical High $870.96 | Professional | None | $363.08 | $457.09 | $870.96 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $6,309.57 | Facility | None | $851.14 | $2,238.72 | $6,309.57 |
United Setting Professional Modifier None Typical Low $208.93 Median $380.19 Typical High $891.25 | Professional | None | $208.93 | $380.19 | $891.25 |
Univera Setting Facility Modifier None Typical Low $295.12 Median $309.03 Typical High $1,412.54 | Facility | None | $295.12 | $309.03 | $1,412.54 |
Univera Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $398.11 | Professional | None | $251.19 | $295.12 | $398.11 |
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 $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $190.55 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $75.86 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $281.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $56.23 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $38.02 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $263.03 | $323.59 | $323.59 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $257.04 Typical High $380.19 | Professional | 54 · Surgery only | $218.78 | $257.04 | $380.19 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $38.02 Typical High $56.23 | Professional | 55 · Aftercare only | $32.36 | $38.02 | $56.23 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $32.36 Typical High $47.86 | Professional | 56 · Pre-op care only | $27.54 | $32.36 | $47.86 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $223.87 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $190.55 | $223.87 | $331.13 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $288.40 | Professional | 53 · Discontinued | $181.97 | $194.98 | $288.40 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $257.04 Typical High $346.74 | Professional | 54 · Surgery only | $218.78 | $257.04 | $346.74 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $38.02 Typical High $114.82 | Professional | 55 · Aftercare only | $32.36 | $38.02 | $114.82 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $32.36 Typical High $97.72 | Professional | 56 · Pre-op care only | $27.54 | $32.36 | $97.72 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $223.87 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $190.55 | $223.87 | $309.03 |
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· 46th of 51
$347
AK $1,349UT $234
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.