How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,202 to $10,233Professionalmedian $724 · 10th to 90th $550 to $1,318
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $1,000.00 | Professional | None | $676.08 | $676.08 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,318.26 | Professional | None | $616.60 | $724.44 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $457.09 Typical High $831.76 | Professional | 62 · Two surgeons | $389.05 | $457.09 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $114.82 Typical High $208.93 | Professional | 80 · Assistant surgeon | $97.72 | $114.82 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $102.33 Typical High $181.97 | Professional | AS · PA/NP assist | $87.10 | $102.33 | $181.97 |
CDPHP Setting Facility Modifier None Typical Low $2,290.87 Median $3,630.78 Typical High $10,964.78 | Facility | None | $2,290.87 | $3,630.78 | $10,964.78 |
CDPHP Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $3,235.94 Typical High $6,606.93 | Facility | None | $1,348.96 | $3,235.94 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $977.24 Typical High $1,445.44 | Professional | None | $512.86 | $977.24 | $1,445.44 |
Emblem Health Setting Facility Modifier None Typical Low $616.60 Median $891.25 Typical High $2,884.03 | Facility | None | $616.60 | $891.25 | $2,884.03 |
Emblem Health Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,513.56 | Professional | None | $794.33 | $870.96 | $1,513.56 |
Excellus BCBS Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $933.25 | Professional | None | $537.03 | $691.83 | $933.25 |
MVP Health Care Setting Facility Modifier None Typical Low $758.58 Median $4,786.30 Typical High $5,754.40 | Facility | None | $758.58 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,412.54 | Professional | None | $933.25 | $933.25 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,549.93 | Facility | None | $1,230.27 | $3,162.28 | $9,549.93 |
United Setting Professional Modifier None Typical Low $457.09 Median $741.31 Typical High $1,318.26 | Professional | None | $457.09 | $741.31 | $1,318.26 |
Univera Setting Facility Modifier None Typical Low $588.84 Median $724.44 Typical High $2,630.27 | Facility | None | $588.84 | $724.44 | $2,630.27 |
Univera Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $933.25 | Professional | None | $537.03 | $691.83 | $933.25 |
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 $338.84 Median $338.84 Typical High $407.38 | Professional | 52 · Reduced service | $338.84 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 53 · Discontinued | $134.90 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | 54 · Surgery only | $512.86 | $512.86 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | 55 · Aftercare only | $102.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $478.63 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $478.63 | $478.63 | $575.44 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $562.34 Typical High $758.58 | Professional | 54 · Surgery only | $436.52 | $562.34 | $758.58 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $131.83 Typical High $177.83 | Professional | 55 · Aftercare only | $102.33 | $131.83 | $177.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $69.18 Typical High $93.33 | Professional | 56 · Pre-op care only | $53.70 | $69.18 | $93.33 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $489.78 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $380.19 | $489.78 | $660.69 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $524.81 Typical High $602.56 | Professional | 53 · Discontinued | $407.38 | $524.81 | $602.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $562.34 Typical High $758.58 | Professional | 54 · Surgery only | $436.52 | $562.34 | $758.58 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $131.83 Typical High $194.98 | Professional | 55 · Aftercare only | $102.33 | $131.83 | $194.98 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $69.18 Typical High $102.33 | Professional | 56 · Pre-op care only | $53.70 | $69.18 | $102.33 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $489.78 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $380.19 | $489.78 | $724.44 |
Where New York sits
The same service costs 8.1 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· 46th of 51
$759
AK $3,236TX $398
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.