How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,122 to $7,943Professionalmedian $1,380 · 10th to 90th $1,122 to $2,344
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 $1,905.46 Median $6,165.95 Typical High $11,748.98 | Facility | None | $1,905.46 | $6,165.95 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $2,818.38 | Professional | None | $1,380.38 | $1,380.38 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,890.45 Typical High $7,943.28 | Facility | None | $1,288.25 | $3,890.45 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,348.96 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $213.80 Typical High $302.00 | Professional | 80 · Assistant surgeon | $181.97 | $213.80 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $190.55 Typical High $263.03 | Professional | AS · PA/NP assist | $158.49 | $190.55 | $263.03 |
CDPHP Setting Facility Modifier None Typical Low $2,570.40 Median $4,073.80 Typical High $12,302.69 | Facility | None | $2,570.40 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,995.26 Typical High $3,019.95 | Facility | None | $1,096.48 | $1,995.26 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $3,090.30 | Professional | None | $1,412.54 | $1,412.54 | $3,090.30 |
Emblem Health Setting Facility Modifier None Typical Low $831.76 Median $1,621.81 Typical High $5,248.07 | Facility | None | $831.76 | $1,621.81 | $5,248.07 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,348.96 | $1,584.89 | $2,454.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $1,862.09 | Professional | None | $812.83 | $1,258.93 | $1,862.09 |
Highmark BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
MVP Health Care Setting Facility Modifier None Typical Low $1,380.38 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,380.38 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $3,630.78 | Professional | None | $1,479.11 | $1,778.28 | $3,630.78 |
United Setting Facility Modifier None Typical Low $831.76 Median $2,290.87 Typical High $6,309.57 | Facility | None | $831.76 | $2,290.87 | $6,309.57 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,479.11 Typical High $3,235.94 | Professional | None | $954.99 | $1,479.11 | $3,235.94 |
Univera Setting Facility Modifier None Typical Low $954.99 Median $1,348.96 Typical High $5,623.41 | Facility | None | $954.99 | $1,348.96 | $5,623.41 |
Univera Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,862.09 | Professional | None | $954.99 | $1,258.93 | $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 $691.83 Median $691.83 Typical High $758.58 | Professional | 52 · Reduced service | $691.83 | $691.83 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $302.00 | Professional | 53 · Discontinued | $275.42 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $229.09 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $151.36 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,047.13 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $1,000.00 Typical High $1,479.11 | Professional | 54 · Surgery only | $630.96 | $1,000.00 | $1,479.11 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $269.15 Typical High $398.11 | Professional | 55 · Aftercare only | $169.82 | $269.15 | $398.11 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $125.89 Typical High $186.21 | Professional | 56 · Pre-op care only | $81.28 | $125.89 | $186.21 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $870.96 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $562.34 | $870.96 | $1,288.25 |
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 $1,000.00 Typical High $1,479.11 | Professional | 54 · Surgery only | $630.96 | $1,000.00 | $1,479.11 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $269.15 Typical High $758.58 | Professional | 55 · Aftercare only | $169.82 | $269.15 | $758.58 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $125.89 Typical High $363.08 | Professional | 56 · Pre-op care only | $81.28 | $125.89 | $363.08 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $870.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $562.34 | $870.96 | $1,348.96 |
Where New York sits
The same service costs 17.0 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· 42nd of 51
$1,380
AK $5,888TX $347
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.