How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,380 to $11,749Professionalmedian $1,023 · 10th to 90th $794 to $2,399
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 $6,309.57 Typical High $12,589.25 | Facility | None | $1,905.46 | $6,309.57 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $3,801.89 | Professional | None | $1,096.48 | $1,096.48 | $3,801.89 |
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 $851.14 Median $1,000.00 Typical High $2,137.96 | Professional | None | $851.14 | $1,000.00 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,479.11 Typical High $3,162.28 | Professional | 50 · Both sides | $1,258.93 | $1,479.11 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $158.49 Typical High $338.84 | Professional | 80 · Assistant surgeon | $134.90 | $158.49 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $138.04 Typical High $295.12 | Professional | AS · PA/NP assist | $117.49 | $138.04 | $295.12 |
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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,584.89 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $4,265.80 | Professional | None | $891.25 | $1,202.26 | $4,265.80 |
Emblem Health Setting Facility Modifier None Typical Low $1,174.90 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,174.90 | $2,089.30 | $4,265.80 |
Emblem Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,258.93 | $2,089.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,445.44 | Professional | None | $776.25 | $977.24 | $1,445.44 |
MVP Health Care Setting Facility Modifier None Typical Low $1,202.26 Median $5,754.40 Typical High $36,307.81 | Facility | None | $1,202.26 | $5,754.40 | $36,307.81 |
MVP Health Care Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,884.03 | Professional | None | $1,479.11 | $1,479.11 | $2,884.03 |
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 $645.65 Median $1,174.90 Typical High $3,235.94 | Professional | None | $645.65 | $1,174.90 | $3,235.94 |
Univera Setting Facility Modifier None Typical Low $891.25 Median $1,071.52 Typical High $4,570.88 | Facility | None | $891.25 | $1,071.52 | $4,570.88 |
Univera Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,348.96 | Professional | None | $776.25 | $977.24 | $1,348.96 |
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 $549.54 Median $549.54 Typical High $707.95 | Professional | 52 · Reduced service | $549.54 | $549.54 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $281.84 | Professional | 53 · Discontinued | $218.78 | $218.78 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $1,047.13 | Professional | 54 · Surgery only | $812.83 | $812.83 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $208.93 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $141.25 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $977.24 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $851.14 Typical High $1,318.26 | Professional | 54 · Surgery only | $676.08 | $851.14 | $1,318.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $138.04 Typical High $213.80 | Professional | 55 · Aftercare only | $109.65 | $138.04 | $213.80 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $69.18 Typical High $107.15 | Professional | 56 · Pre-op care only | $54.95 | $69.18 | $107.15 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $776.25 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $616.60 | $776.25 | $1,202.26 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $776.25 Typical High $1,174.90 | Professional | 53 · Discontinued | $588.84 | $776.25 | $1,174.90 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $851.14 Typical High $1,258.93 | Professional | 54 · Surgery only | $676.08 | $851.14 | $1,258.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $138.04 Typical High $316.23 | Professional | 55 · Aftercare only | $109.65 | $138.04 | $316.23 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $69.18 Typical High $158.49 | Professional | 56 · Pre-op care only | $54.95 | $69.18 | $158.49 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $776.25 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $616.60 | $776.25 | $1,148.15 |
Where New York sits
The same service costs 6.8 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
$1,072
AK $4,677TX $692
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.