How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,622 to $11,749Professionalmedian $2,692 · 10th to 90th $2,188 to $4,467
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 $2,951.21 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,951.21 | $3,235.94 | $3,235.94 |
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 $2,290.87 Median $2,691.53 Typical High $3,548.13 | Professional | None | $2,290.87 | $2,691.53 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $436.52 Typical High $575.44 | Professional | 80 · Assistant surgeon | $371.54 | $436.52 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $380.19 Typical High $549.54 | Professional | AS · PA/NP assist | $323.59 | $380.19 | $549.54 |
CDPHP Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
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 $2,691.53 Median $2,691.53 Typical High $6,309.57 | Professional | None | $2,691.53 | $2,691.53 | $6,309.57 |
Emblem Health Setting Facility Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $9,332.54 | Facility | None | $2,818.38 | $4,168.69 | $9,332.54 |
Emblem Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $4,677.35 | Professional | None | $2,398.83 | $2,398.83 | $4,677.35 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $2,290.87 Typical High $3,630.78 | Professional | None | $1,584.89 | $2,290.87 | $3,630.78 |
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 $2,951.21 Median $3,981.07 Typical High $6,918.31 | Professional | None | $2,951.21 | $3,981.07 | $6,918.31 |
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 $1,698.24 Median $2,754.23 Typical High $6,606.93 | Professional | None | $1,698.24 | $2,754.23 | $6,606.93 |
Univera Setting Facility Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $12,589.25 | Facility | None | $1,862.09 | $2,089.30 | $12,589.25 |
Univera Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $3,630.78 | Professional | None | $1,862.09 | $2,290.87 | $3,630.78 |
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 $1,479.11 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,479.11 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $588.84 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,187.76 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $436.52 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,290.87 | $2,290.87 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,819.70 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,258.93 | $1,819.70 | $3,090.30 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $478.63 Typical High $831.76 | Professional | 55 · Aftercare only | $331.13 | $478.63 | $831.76 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $229.09 Typical High $389.05 | Professional | 56 · Pre-op care only | $158.49 | $229.09 | $389.05 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,584.89 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,584.89 | $2,691.53 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,445.44 Median $1,513.56 Typical High $2,137.96 | Professional | 53 · Discontinued | $1,445.44 | $1,513.56 | $2,137.96 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,819.70 Typical High $2,884.03 | Professional | 54 · Surgery only | $1,258.93 | $1,819.70 | $2,884.03 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $489.78 Typical High $1,479.11 | Professional | 55 · Aftercare only | $331.13 | $489.78 | $1,479.11 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $234.42 Typical High $707.95 | Professional | 56 · Pre-op care only | $158.49 | $234.42 | $707.95 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,621.81 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,621.81 | $2,511.89 |
Where New York sits
The same service costs 20.9 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· 45th of 51
$2,692
AK $11,220TX $537
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.