How much rates vary
Facilitymedian $3,548 · 10th to 90th $1,148 to $8,128Professionalmedian $871 · 10th to 90th $692 to $1,380
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 $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,148.15 | $1,148.15 | $1,348.96 |
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 $741.31 Median $870.96 Typical High $1,318.26 | Professional | None | $741.31 | $870.96 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,318.26 Typical High $1,949.84 | Professional | 50 · Both sides | $1,122.02 | $1,318.26 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $141.25 Typical High $204.17 | Professional | 80 · Assistant surgeon | $120.23 | $141.25 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $123.03 Typical High $181.97 | Professional | AS · PA/NP assist | $104.71 | $123.03 | $181.97 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $4,265.80 | Facility | None | $1,479.11 | $2,137.96 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $2,187.76 | Professional | None | $794.33 | $831.76 | $2,187.76 |
Emblem Health Setting Facility Modifier None Typical Low $776.25 Median $1,071.52 Typical High $3,311.31 | Facility | None | $776.25 | $1,071.52 | $3,311.31 |
Emblem Health Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,548.82 | Professional | None | $870.96 | $1,000.00 | $1,548.82 |
Excellus BCBS Setting Professional Modifier None Typical Low $501.19 Median $812.83 Typical High $1,288.25 | Professional | None | $501.19 | $812.83 | $1,288.25 |
MVP Health Care Setting Facility Modifier None Typical Low $891.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $891.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,380.38 | Professional | None | $524.81 | $524.81 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,244.36 | Facility | None | $1,122.02 | $2,754.23 | $7,244.36 |
United Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,513.56 | Professional | None | $660.69 | $977.24 | $1,513.56 |
Univera Setting Facility Modifier None Typical Low $870.96 Median $933.25 Typical High $2,754.23 | Facility | None | $870.96 | $933.25 | $2,754.23 |
Univera Setting Professional Modifier None Typical Low $501.19 Median $812.83 Typical High $1,288.25 | Professional | None | $501.19 | $812.83 | $1,288.25 |
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 $575.44 Median $575.44 Typical High $676.08 | Professional | 52 · Reduced service | $575.44 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | 53 · Discontinued | $229.09 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Professional | 54 · Surgery only | $851.14 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $199.53 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $933.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $660.69 Typical High $1,047.13 | Professional | 54 · Surgery only | $562.34 | $660.69 | $1,047.13 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $162.18 Typical High $257.04 | Professional | 55 · Aftercare only | $138.04 | $162.18 | $257.04 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $81.28 Typical High $128.82 | Professional | 56 · Pre-op care only | $69.18 | $81.28 | $128.82 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $575.44 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $489.78 | $575.44 | $912.01 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $616.60 Typical High $870.96 | Professional | 53 · Discontinued | $489.78 | $616.60 | $870.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $676.08 Typical High $1,047.13 | Professional | 54 · Surgery only | $562.34 | $676.08 | $1,047.13 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $169.82 Typical High $380.19 | Professional | 55 · Aftercare only | $138.04 | $169.82 | $380.19 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $85.11 Typical High $190.55 | Professional | 56 · Pre-op care only | $69.18 | $85.11 | $190.55 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $588.84 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $489.78 | $588.84 | $912.01 |
Where New York sits
The same service costs 7.2 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
$912
AK $3,981UT $550
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.