How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,549 to $11,749Professionalmedian $1,622 · 10th to 90th $1,288 to $3,802
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 $2,238.72 Median $6,309.57 Typical High $12,589.25 | Facility | None | $2,238.72 | $6,309.57 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $5,128.61 | Professional | None | $1,737.80 | $1,737.80 | $5,128.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,659.59 | $6,309.57 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $3,388.44 | Professional | None | $1,348.96 | $1,584.89 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,398.83 Typical High $5,128.61 | Professional | 50 · Both sides | $2,041.74 | $2,398.83 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $257.04 Typical High $549.54 | Professional | 80 · Assistant surgeon | $218.78 | $257.04 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $223.87 Typical High $478.63 | Professional | AS · PA/NP assist | $190.55 | $223.87 | $478.63 |
CDPHP Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $12,302.69 | Facility | None | $4,073.80 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,621.81 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,949.84 Typical High $6,918.31 | Professional | None | $1,412.54 | $1,949.84 | $6,918.31 |
Emblem Health Setting Facility Modifier None Typical Low $1,778.28 Median $3,311.31 Typical High $6,760.83 | Facility | None | $1,778.28 | $3,311.31 | $6,760.83 |
Emblem Health Setting Professional Modifier None Typical Low $1,737.80 Median $1,995.26 Typical High $3,311.31 | Professional | None | $1,737.80 | $1,995.26 | $3,311.31 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,548.82 | $2,344.23 |
MVP Health Care Setting Facility Modifier None Typical Low $1,949.84 Median $5,754.40 Typical High $36,307.81 | Facility | None | $1,949.84 | $5,754.40 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $4,677.35 | Professional | None | $1,995.26 | $1,995.26 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,589.25 | Facility | None | $1,318.26 | $3,548.13 | $12,589.25 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,862.09 Typical High $5,128.61 | Professional | None | $1,047.13 | $1,862.09 | $5,128.61 |
Univera Setting Facility Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $6,456.54 | Facility | None | $1,445.44 | $1,698.24 | $6,456.54 |
Univera Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,258.93 | $1,548.82 | $2,187.76 |
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 $870.96 Median $870.96 Typical High $1,122.02 | Professional | 52 · Reduced service | $870.96 | $870.96 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $457.09 | Professional | 53 · Discontinued | $346.74 | $346.74 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $223.87 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,584.89 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,348.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,071.52 | $1,348.96 | $2,137.96 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $218.78 Typical High $346.74 | Professional | 55 · Aftercare only | $173.78 | $218.78 | $346.74 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $109.65 Typical High $173.78 | Professional | 56 · Pre-op care only | $87.10 | $109.65 | $173.78 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,230.27 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,230.27 | $1,949.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $1,258.93 Typical High $1,905.46 | Professional | 53 · Discontinued | $933.25 | $1,258.93 | $1,905.46 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,348.96 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,071.52 | $1,348.96 | $1,995.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $218.78 Typical High $512.86 | Professional | 55 · Aftercare only | $173.78 | $218.78 | $512.86 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $109.65 Typical High $257.04 | Professional | 56 · Pre-op care only | $87.10 | $109.65 | $257.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,258.93 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,258.93 | $1,862.09 |
Where New York sits
The same service costs 6.9 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· 48th of 51
$1,698
AK $7,586TX $1,096
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.