How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,445 to $11,749Professionalmedian $1,349 · 10th to 90th $1,096 to $2,291
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 $6,025.60 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,025.60 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,479.11 | Professional | None | $1,288.25 | $1,288.25 | $1,479.11 |
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 $1,148.15 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,148.15 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $218.78 Typical High $288.40 | Professional | 80 · Assistant surgeon | $186.21 | $218.78 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $190.55 Typical High $257.04 | Professional | AS · PA/NP assist | $162.18 | $190.55 | $257.04 |
CDPHP Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
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 $1,380.38 Median $1,380.38 Typical High $3,162.28 | Professional | None | $1,380.38 | $1,380.38 | $3,162.28 |
Emblem Health Setting Facility Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $4,897.79 | Facility | None | $1,258.93 | $1,548.82 | $4,897.79 |
Emblem Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,513.56 | $2,398.83 |
Excellus BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $1,862.09 | Professional | None | $794.33 | $1,202.26 | $1,862.09 |
MVP Health Care Setting Facility Modifier None Typical Low $1,348.96 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,348.96 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $3,548.13 | Professional | None | $1,479.11 | $1,584.89 | $3,548.13 |
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 $891.25 Median $1,445.44 Typical High $3,388.44 | Professional | None | $891.25 | $1,445.44 | $3,388.44 |
Univera Setting Facility Modifier None Typical Low $933.25 Median $1,288.25 Typical High $5,011.87 | Facility | None | $933.25 | $1,288.25 | $5,011.87 |
Univera Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,862.09 | Professional | None | $933.25 | $1,202.26 | $1,862.09 |
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 $645.65 Median $645.65 Typical High $724.44 | Professional | 52 · Reduced service | $645.65 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $295.12 | Professional | 53 · Discontinued | $257.04 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,096.48 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $218.78 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,023.29 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $954.99 Typical High $1,445.44 | Professional | 54 · Surgery only | $630.96 | $954.99 | $1,445.44 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $251.19 Typical High $389.05 | Professional | 55 · Aftercare only | $165.96 | $251.19 | $389.05 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $120.23 Typical High $186.21 | Professional | 56 · Pre-op care only | $79.43 | $120.23 | $186.21 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $831.76 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $549.54 | $831.76 | $1,258.93 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $758.58 Typical High $1,096.48 | Professional | 53 · Discontinued | $741.31 | $758.58 | $1,096.48 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $954.99 Typical High $1,445.44 | Professional | 54 · Surgery only | $630.96 | $954.99 | $1,445.44 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $251.19 Typical High $758.58 | Professional | 55 · Aftercare only | $165.96 | $251.19 | $758.58 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $120.23 Typical High $363.08 | Professional | 56 · Pre-op care only | $79.43 | $120.23 | $363.08 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $831.76 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $549.54 | $831.76 | $1,288.25 |
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· 44th of 51
$1,349
AK $5,754TX $288
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.