How much rates vary
Facilitymedian $4,786 · 10th to 90th $1,318 to $10,965Professionalmedian $1,122 · 10th to 90th $891 to $1,778
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 $5,623.41 Typical High $9,772.37 | Facility | None | $1,819.70 | $5,623.41 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,202.26 | $1,230.27 |
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 $954.99 Median $1,122.02 Typical High $1,479.11 | Professional | None | $954.99 | $1,122.02 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $707.95 Typical High $870.96 | Professional | 62 · Two surgeons | $602.56 | $707.95 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $181.97 Typical High $223.87 | Professional | 80 · Assistant surgeon | $151.36 | $181.97 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $158.49 Typical High $213.80 | Professional | AS · PA/NP assist | $134.90 | $158.49 | $213.80 |
CDPHP Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $12,302.69 | Facility | None | $4,073.80 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $4,897.79 Typical High $10,000.00 | Facility | None | $1,584.89 | $4,897.79 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $2,454.71 | Professional | None | $977.24 | $977.24 | $2,454.71 |
Emblem Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $3,548.13 | Facility | None | $1,071.52 | $1,445.44 | $3,548.13 |
Emblem Health Setting Professional Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,659.59 | Professional | None | $933.25 | $1,071.52 | $1,659.59 |
Excellus BCBS Setting Professional Modifier None Typical Low $575.44 Median $870.96 Typical High $1,318.26 | Professional | None | $575.44 | $870.96 | $1,318.26 |
MVP Health Care Setting Facility Modifier None Typical Low $1,174.90 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,174.90 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,754.23 | Professional | None | $1,148.15 | $1,445.44 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $2,754.23 Typical High $8,709.64 | Facility | None | $1,122.02 | $2,754.23 | $8,709.64 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,096.48 Typical High $2,398.83 | Professional | None | $630.96 | $1,096.48 | $2,398.83 |
Univera Setting Facility Modifier None Typical Low $676.08 Median $933.25 Typical High $4,466.84 | Facility | None | $676.08 | $933.25 | $4,466.84 |
Univera Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,318.26 | Professional | None | $676.08 | $870.96 | $1,318.26 |
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 $537.03 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $218.78 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $812.83 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $162.18 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $109.65 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $758.58 | $851.14 | $851.14 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $691.83 Typical High $1,122.02 | Professional | 54 · Surgery only | $457.09 | $691.83 | $1,122.02 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $181.97 Typical High $302.00 | Professional | 55 · Aftercare only | $120.23 | $181.97 | $302.00 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $87.10 Typical High $141.25 | Professional | 56 · Pre-op care only | $57.54 | $87.10 | $141.25 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $602.56 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $398.11 | $602.56 | $977.24 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $831.76 | Professional | 53 · Discontinued | $575.44 | $575.44 | $831.76 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $691.83 Typical High $1,047.13 | Professional | 54 · Surgery only | $457.09 | $691.83 | $1,047.13 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $181.97 Typical High $537.03 | Professional | 55 · Aftercare only | $120.23 | $181.97 | $537.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $87.10 Typical High $257.04 | Professional | 56 · Pre-op care only | $57.54 | $87.10 | $257.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $602.56 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $398.11 | $602.56 | $933.25 |
Where New York sits
The same service costs 7.9 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· 41st of 51
$1,122
AK $4,074TX $513
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.