How much rates vary
Facilitymedian $2,818 · 10th to 90th $646 to $5,754Professionalmedian $537 · 10th to 90th $437 to $891
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 $562.34 Median $562.34 Typical High $562.34 | Professional | None | $562.34 | $562.34 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $724.44 | Professional | None | $446.68 | $524.81 | $724.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $281.84 Median $331.13 Typical High $457.09 | Professional | 62 · Two surgeons | $281.84 | $331.13 | $457.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $83.18 Typical High $112.20 | Professional | 80 · Assistant surgeon | $70.79 | $83.18 | $112.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $61.66 Median $72.44 Typical High $100.00 | Professional | AS · PA/NP assist | $61.66 | $72.44 | $100.00 |
CDPHP Setting Facility Modifier None Typical Low $1,905.46 Median $2,951.21 Typical High $8,912.51 | Facility | None | $1,905.46 | $2,951.21 | $8,912.51 |
CDPHP Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $891.25 Typical High $1,862.09 | Facility | None | $537.03 | $891.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,202.26 | Professional | None | $537.03 | $537.03 | $1,202.26 |
Emblem Health Setting Facility Modifier None Typical Low $524.81 Median $630.96 Typical High $2,137.96 | Facility | None | $524.81 | $630.96 | $2,137.96 |
Emblem Health Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $933.25 | Professional | None | $501.19 | $616.60 | $933.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $724.44 | Professional | None | $309.03 | $489.78 | $724.44 |
MVP Health Care Setting Facility Modifier None Typical Low $549.54 Median $3,235.94 Typical High $4,365.16 | Facility | None | $549.54 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,380.38 | Professional | None | $562.34 | $691.83 | $1,380.38 |
United Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $4,897.79 | Facility | None | $549.54 | $1,737.80 | $4,897.79 |
United Setting Professional Modifier None Typical Low $371.54 Median $562.34 Typical High $1,230.27 | Professional | None | $371.54 | $562.34 | $1,230.27 |
Univera Setting Facility Modifier None Typical Low $363.08 Median $501.19 Typical High $2,511.89 | Facility | None | $363.08 | $501.19 | $2,511.89 |
Univera Setting Professional Modifier None Typical Low $363.08 Median $489.78 Typical High $724.44 | Professional | None | $363.08 | $489.78 | $724.44 |
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 $275.42 Median $275.42 Typical High $281.84 | Professional | 52 · Reduced service | $275.42 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $426.58 | Professional | 54 · Surgery only | $416.87 | $416.87 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $85.11 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $398.11 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $389.05 Typical High $602.56 | Professional | 54 · Surgery only | $245.47 | $389.05 | $602.56 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $102.33 Typical High $162.18 | Professional | 55 · Aftercare only | $66.07 | $102.33 | $162.18 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $48.98 Typical High $77.62 | Professional | 56 · Pre-op care only | $30.90 | $48.98 | $77.62 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $338.84 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $213.80 | $338.84 | $537.03 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $288.40 Typical High $416.87 | Professional | 53 · Discontinued | $281.84 | $288.40 | $416.87 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $389.05 Typical High $562.34 | Professional | 54 · Surgery only | $245.47 | $389.05 | $562.34 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $102.33 Typical High $288.40 | Professional | 55 · Aftercare only | $66.07 | $102.33 | $288.40 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $48.98 Typical High $138.04 | Professional | 56 · Pre-op care only | $30.90 | $48.98 | $138.04 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $338.84 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $213.80 | $338.84 | $501.19 |
Where New York sits
The same service costs 6.3 times more in Alaska than in Utah. 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
$537
AK $2,239UT $355
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.