How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,660 to $14,454Professionalmedian $2,512 · 10th to 90th $2,042 to $4,365
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 $6,165.95 Typical High $10,964.78 | Facility | None | $2,238.72 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $8,511.38 Typical High $15,135.61 | Facility | None | $1,778.28 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,454.71 Typical High $3,548.13 | Professional | None | $2,089.30 | $2,454.71 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,548.82 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,318.26 | $1,548.82 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $338.84 Median $398.11 Typical High $575.44 | Professional | 80 · Assistant surgeon | $338.84 | $398.11 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $346.74 Typical High $501.19 | Professional | AS · PA/NP assist | $295.12 | $346.74 | $501.19 |
CDPHP Setting Professional Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,715.35 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $7,585.78 Typical High $15,488.17 | Facility | None | $1,737.80 | $7,585.78 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $6,025.60 | Professional | None | $2,630.27 | $2,630.27 | $6,025.60 |
Emblem Health Setting Facility Modifier None Typical Low $2,818.38 Median $4,073.80 Typical High $9,120.11 | Facility | None | $2,818.38 | $4,073.80 | $9,120.11 |
Emblem Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,818.38 Typical High $4,466.84 | Professional | None | $2,398.83 | $2,818.38 | $4,466.84 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $2,238.72 Typical High $4,365.16 | Professional | None | $1,230.27 | $2,238.72 | $4,365.16 |
MVP Health Care Setting Facility Modifier None Typical Low $2,818.38 Median $4,786.30 Typical High $5,754.40 | Facility | None | $2,818.38 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,754.23 Median $3,630.78 Typical High $6,760.83 | Professional | None | $2,754.23 | $3,630.78 | $6,760.83 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $14,125.38 | Facility | None | $1,318.26 | $4,073.80 | $14,125.38 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,691.53 Typical High $6,309.57 | Professional | None | $1,698.24 | $2,691.53 | $6,309.57 |
Univera Setting Facility Modifier None Typical Low $1,479.11 Median $2,398.83 Typical High $11,220.18 | Facility | None | $1,479.11 | $2,398.83 | $11,220.18 |
Univera Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $4,365.16 | Professional | None | $1,479.11 | $2,238.72 | $4,365.16 |
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 $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $2,041.74 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $407.38 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,905.46 | $1,949.84 | $1,949.84 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,778.28 Typical High $3,467.37 | Professional | 54 · Surgery only | $977.24 | $1,778.28 | $3,467.37 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $467.74 Typical High $933.25 | Professional | 55 · Aftercare only | $263.03 | $467.74 | $933.25 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $223.87 Typical High $436.52 | Professional | 56 · Pre-op care only | $123.03 | $223.87 | $436.52 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,548.82 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $851.14 | $1,548.82 | $3,019.95 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,380.38 Median $1,412.54 Typical High $2,089.30 | Professional | 53 · Discontinued | $1,380.38 | $1,412.54 | $2,089.30 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,778.28 Typical High $3,467.37 | Professional | 54 · Surgery only | $977.24 | $1,778.28 | $3,467.37 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $467.74 Typical High $1,380.38 | Professional | 55 · Aftercare only | $263.03 | $467.74 | $1,380.38 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $223.87 Typical High $660.69 | Professional | 56 · Pre-op care only | $123.03 | $223.87 | $660.69 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,548.82 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $851.14 | $1,548.82 | $3,019.95 |
Where New York sits
The same service costs 8.7 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· 44th of 51
$2,570
AK $10,715TX $1,230
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.