How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,202 to $10,471Professionalmedian $513 · 10th to 90th $398 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 $5,248.07 Typical High $9,120.11 | Facility | None | $1,819.70 | $5,248.07 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $630.96 | Professional | None | $549.54 | $549.54 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,513.56 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $724.44 | Professional | None | $416.87 | $489.78 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $79.43 Typical High $114.82 | Professional | 80 · Assistant surgeon | $67.61 | $79.43 | $114.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $69.18 Typical High $100.00 | Professional | AS · PA/NP assist | $58.88 | $69.18 | $100.00 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,584.89 | $2,089.30 | $6,165.95 |
CDPHP Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,754.23 Typical High $5,370.32 | Facility | None | $1,148.15 | $2,754.23 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $1,258.93 | Professional | None | $524.81 | $524.81 | $1,258.93 |
Emblem Health Setting Facility Modifier None Typical Low $204.17 Median $588.84 Typical High $1,949.84 | Facility | None | $204.17 | $588.84 | $1,949.84 |
Emblem Health Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $977.24 | Professional | None | $588.84 | $588.84 | $977.24 |
Excellus BCBS Setting Professional Modifier None Typical Low $302.00 Median $467.74 Typical High $691.83 | Professional | None | $302.00 | $467.74 | $691.83 |
MVP Health Care Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
MVP Health Care Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $1,348.96 | Professional | None | $549.54 | $630.96 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $4,073.80 Typical High $12,589.25 | Facility | None | $1,318.26 | $4,073.80 | $12,589.25 |
United Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $1,288.25 | Professional | None | $354.81 | $549.54 | $1,288.25 |
Univera Setting Facility Modifier None Typical Low $354.81 Median $398.11 Typical High $2,818.38 | Facility | None | $354.81 | $398.11 | $2,818.38 |
Univera Setting Professional Modifier None Typical Low $354.81 Median $446.68 Typical High $691.83 | Professional | None | $354.81 | $446.68 | $691.83 |
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 $269.15 Median $269.15 Typical High $309.03 | Professional | 52 · Reduced service | $269.15 | $269.15 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $125.89 | Professional | 53 · Discontinued | $109.65 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $467.74 | Professional | 54 · Surgery only | $407.38 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $93.33 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $436.52 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $371.54 Typical High $588.84 | Professional | 54 · Surgery only | $239.88 | $371.54 | $588.84 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $100.00 Typical High $158.49 | Professional | 55 · Aftercare only | $63.10 | $100.00 | $158.49 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $46.77 Typical High $74.13 | Professional | 56 · Pre-op care only | $30.20 | $46.77 | $74.13 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $323.59 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $208.93 | $323.59 | $512.86 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $281.84 Typical High $416.87 | Professional | 53 · Discontinued | $275.42 | $281.84 | $416.87 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $371.54 Typical High $549.54 | Professional | 54 · Surgery only | $239.88 | $371.54 | $549.54 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $100.00 Typical High $281.84 | Professional | 55 · Aftercare only | $63.10 | $100.00 | $281.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $46.77 Typical High $134.90 | Professional | 56 · Pre-op care only | $30.20 | $46.77 | $134.90 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $323.59 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $208.93 | $323.59 | $478.63 |
Where New York sits
The same service costs 6.6 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· 46th of 51
$525
AK $2,188UT $331
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.