How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,023 to $7,762Professionalmedian $427 · 10th to 90th $347 to $794
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 $524.81 Median $537.03 Typical High $537.03 | Professional | None | $524.81 | $537.03 | $537.03 |
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 $363.08 Median $426.58 Typical High $602.56 | Professional | None | $363.08 | $426.58 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $645.65 Typical High $891.25 | Professional | 50 · Both sides | $549.54 | $645.65 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $57.54 Median $67.61 Typical High $95.50 | Professional | 80 · Assistant surgeon | $57.54 | $67.61 | $95.50 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $60.26 Typical High $83.18 | Professional | AS · PA/NP assist | $51.29 | $60.26 | $83.18 |
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 $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
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 $389.05 Median $389.05 Typical High $1,071.52 | Professional | None | $389.05 | $389.05 | $1,071.52 |
Emblem Health Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $1,778.28 | Facility | None | $446.68 | $537.03 | $1,778.28 |
Emblem Health Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $851.14 | Professional | None | $512.86 | $512.86 | $851.14 |
Excellus BCBS Setting Professional Modifier None Typical Low $346.74 Median $407.38 Typical High $562.34 | Professional | None | $346.74 | $407.38 | $562.34 |
MVP Health Care Setting Facility Modifier None Typical Low $3,235.94 Median $4,365.16 Typical High $36,307.81 | Facility | None | $3,235.94 | $4,365.16 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $1,174.90 | Professional | None | $489.78 | $537.03 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,511.89 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,511.89 | $7,244.36 |
United Setting Professional Modifier None Typical Low $288.40 Median $537.03 Typical High $1,258.93 | Professional | None | $288.40 | $537.03 | $1,258.93 |
Univera Setting Facility Modifier None Typical Low $346.74 Median $416.87 Typical High $1,621.81 | Facility | None | $346.74 | $416.87 | $1,621.81 |
Univera Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $537.03 | Professional | None | $346.74 | $389.05 | $537.03 |
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 $263.03 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $263.03 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $104.71 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $52.48 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $371.54 | $371.54 | $371.54 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $354.81 Typical High $512.86 | Professional | 54 · Surgery only | $302.00 | $354.81 | $512.86 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $53.70 Typical High $77.62 | Professional | 55 · Aftercare only | $45.71 | $53.70 | $77.62 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $45.71 Typical High $64.57 | Professional | 56 · Pre-op care only | $38.90 | $45.71 | $64.57 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $316.23 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $263.03 | $316.23 | $446.68 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $389.05 | Professional | 53 · Discontinued | $245.47 | $263.03 | $389.05 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $354.81 Typical High $467.74 | Professional | 54 · Surgery only | $302.00 | $354.81 | $467.74 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $53.70 Typical High $154.88 | Professional | 55 · Aftercare only | $45.71 | $53.70 | $154.88 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $45.71 Typical High $131.83 | Professional | 56 · Pre-op care only | $38.90 | $45.71 | $131.83 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $316.23 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $263.03 | $316.23 | $407.38 |
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· 47th of 51
$447
AK $1,862UT $324
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.