How much rates vary
Facilitymedian $3,631 · 10th to 90th $1,023 to $8,318Professionalmedian $692 · 10th to 90th $501 to $1,122
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 $1,445.44 Median $6,165.95 Typical High $12,882.50 | Facility | None | $1,445.44 | $6,165.95 | $12,882.50 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $691.83 Typical High $831.76 | Professional | None | $660.69 | $691.83 | $831.76 |
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 $630.96 Median $741.31 Typical High $891.25 | Professional | None | $630.96 | $741.31 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $117.49 Typical High $141.25 | Professional | 80 · Assistant surgeon | $100.00 | $117.49 | $141.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $102.33 Typical High $123.03 | Professional | AS · PA/NP assist | $87.10 | $102.33 | $123.03 |
CDPHP Setting Facility Modifier None Typical Low $3,388.44 Median $4,466.84 Typical High $13,489.63 | Facility | None | $3,388.44 | $4,466.84 | $13,489.63 |
CDPHP Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | None | $776.25 | $776.25 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $3,630.78 Typical High $7,244.36 | Facility | None | $1,737.80 | $3,630.78 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $1,348.96 | Professional | None | $489.78 | $588.84 | $1,348.96 |
Emblem Health Setting Facility Modifier None Typical Low $562.34 Median $776.25 Typical High $1,995.26 | Facility | None | $562.34 | $776.25 | $1,995.26 |
Emblem Health Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,174.90 | Professional | None | $562.34 | $776.25 | $1,174.90 |
Excellus BCBS Setting Professional Modifier None Typical Low $363.08 Median $616.60 Typical High $831.76 | Professional | None | $363.08 | $616.60 | $831.76 |
MVP Health Care Setting Facility Modifier None Typical Low $660.69 Median $4,786.30 Typical High $5,754.40 | Facility | None | $660.69 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $707.95 Median $724.44 Typical High $1,659.59 | Professional | None | $707.95 | $724.44 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $7,762.47 | Facility | None | $1,122.02 | $2,754.23 | $7,762.47 |
United Setting Professional Modifier None Typical Low $380.19 Median $630.96 Typical High $1,318.26 | Professional | None | $380.19 | $630.96 | $1,318.26 |
Univera Setting Facility Modifier None Typical Low $363.08 Median $562.34 Typical High $2,187.76 | Facility | None | $363.08 | $562.34 | $2,187.76 |
Univera Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $831.76 | Professional | None | $426.58 | $616.60 | $831.76 |
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 $331.13 Median $346.74 Typical High $416.87 | Professional | 52 · Reduced service | $331.13 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $138.04 Typical High $165.96 | Professional | 53 · Discontinued | $131.83 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $630.96 | Professional | 54 · Surgery only | $501.19 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $125.89 | Professional | 55 · Aftercare only | $100.00 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $69.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $66.07 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $489.78 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $467.74 | $489.78 | $588.84 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $489.78 Typical High $660.69 | Professional | 54 · Surgery only | $288.40 | $489.78 | $660.69 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $131.83 Typical High $177.83 | Professional | 55 · Aftercare only | $75.86 | $131.83 | $177.83 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $61.66 Typical High $83.18 | Professional | 56 · Pre-op care only | $36.31 | $61.66 | $83.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $426.58 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $251.19 | $426.58 | $575.44 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $363.08 Typical High $512.86 | Professional | 53 · Discontinued | $354.81 | $363.08 | $512.86 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $489.78 Typical High $660.69 | Professional | 54 · Surgery only | $288.40 | $489.78 | $660.69 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $131.83 Typical High $338.84 | Professional | 55 · Aftercare only | $75.86 | $131.83 | $338.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $61.66 Typical High $162.18 | Professional | 56 · Pre-op care only | $36.31 | $61.66 | $162.18 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $426.58 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $251.19 | $426.58 | $575.44 |
Where New York sits
The same service costs 6.2 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· 38th of 51
$692
AK $2,570TX $417
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.