How much rates vary
Facilitymedian $5,248 · 10th to 90th $1,514 to $11,749Professionalmedian $1,738 · 10th to 90th $1,380 to $2,951
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 $2,089.30 Median $6,025.60 Typical High $10,964.78 | Facility | None | $2,089.30 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,905.46 | $2,089.30 | $2,089.30 |
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 $1,445.44 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,698.24 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $275.42 Typical High $380.19 | Professional | 80 · Assistant surgeon | $234.42 | $275.42 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $239.88 Typical High $338.84 | Professional | AS · PA/NP assist | $204.17 | $239.88 | $338.84 |
CDPHP Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,737.80 | $6,309.57 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $4,073.80 | Professional | None | $1,737.80 | $1,737.80 | $4,073.80 |
Emblem Health Setting Facility Modifier None Typical Low $1,819.70 Median $2,691.53 Typical High $6,025.60 | Facility | None | $1,819.70 | $2,691.53 | $6,025.60 |
Emblem Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,819.70 | $1,819.70 | $3,019.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,023.29 | $1,479.11 | $2,344.23 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,786.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $4,466.84 | Professional | None | $1,862.09 | $2,511.89 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,318.26 | $3,548.13 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $4,265.80 | Professional | None | $1,096.48 | $1,778.28 | $4,265.80 |
Univera Setting Facility Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $8,511.38 | Facility | None | $1,202.26 | $1,348.96 | $8,511.38 |
Univera Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,479.11 | $2,344.23 |
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 $954.99 Median $1,023.29 Typical High $1,047.13 | Professional | 52 · Reduced service | $954.99 | $1,023.29 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $380.19 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,412.54 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $281.84 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $190.55 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,445.44 | $1,445.44 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,174.90 Typical High $1,862.09 | Professional | 54 · Surgery only | $812.83 | $1,174.90 | $1,862.09 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $316.23 Typical High $489.78 | Professional | 55 · Aftercare only | $213.80 | $316.23 | $489.78 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $147.91 Typical High $234.42 | Professional | 56 · Pre-op care only | $102.33 | $147.91 | $234.42 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,023.29 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $707.95 | $1,023.29 | $1,621.81 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $977.24 Typical High $1,380.38 | Professional | 53 · Discontinued | $933.25 | $977.24 | $1,380.38 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,174.90 Typical High $1,862.09 | Professional | 54 · Surgery only | $812.83 | $1,174.90 | $1,862.09 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $316.23 Typical High $977.24 | Professional | 55 · Aftercare only | $213.80 | $316.23 | $977.24 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $151.36 Typical High $467.74 | Professional | 56 · Pre-op care only | $102.33 | $151.36 | $467.74 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $1,047.13 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $707.95 | $1,047.13 | $1,621.81 |
Where New York sits
The same service costs 20.0 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
$1,738
AK $7,244TX $363
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.