How much rates vary
Facilitymedian $5,129 · 10th to 90th $1,148 to $13,183Professionalmedian $2,951 · 10th to 90th $269 to $6,166
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 $1,174.90 Median $4,897.79 Typical High $10,471.29 | Facility | None | $1,174.90 | $4,897.79 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $3,548.13 Typical High $4,168.69 | Professional | None | $269.15 | $3,548.13 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $7,413.10 Typical High $14,454.40 | Facility | None | $1,659.59 | $7,413.10 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,630.27 Median $3,162.28 Typical High $6,309.57 | Professional | None | $2,630.27 | $3,162.28 | $6,309.57 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,981.07 Median $4,786.30 Typical High $9,549.93 | Professional | 50 · Both sides | $3,981.07 | $4,786.30 | $9,549.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $512.86 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $426.58 | $512.86 | $1,000.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $446.68 Typical High $891.25 | Professional | AS · PA/NP assist | $380.19 | $446.68 | $891.25 |
CDPHP Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $12,302.69 | Facility | None | $1,584.89 | $4,073.80 | $12,302.69 |
CDPHP Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $5,011.87 | Professional | None | $354.81 | $354.81 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $4,073.80 Typical High $8,317.64 | Facility | None | $1,445.44 | $4,073.80 | $8,317.64 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $2,511.89 Typical High $9,549.93 | Professional | None | $194.98 | $2,511.89 | $9,549.93 |
Emblem Health Setting Facility Modifier None Typical Low $218.78 Median $269.15 Typical High $891.25 | Facility | None | $218.78 | $269.15 | $891.25 |
Emblem Health Setting Professional Modifier None Typical Low $3,235.94 Median $3,715.35 Typical High $6,025.60 | Professional | None | $3,235.94 | $3,715.35 | $6,025.60 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $2,818.38 Typical High $3,981.07 | Professional | None | $1,659.59 | $2,818.38 | $3,981.07 |
Highmark BCBS Setting Facility Modifier None Typical Low $426.58 Median $446.68 Typical High $2,137.96 | Facility | None | $426.58 | $446.68 | $2,137.96 |
MVP Health Care Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $1,819.70 | Facility | None | $302.00 | $302.00 | $1,819.70 |
MVP Health Care Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $6,165.95 | Professional | None | $2,884.03 | $2,884.03 | $6,165.95 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,388.44 Typical High $10,471.29 | Facility | None | $1,230.27 | $3,388.44 | $10,471.29 |
United Setting Professional Modifier None Typical Low $194.98 Median $1,698.24 Typical High $7,079.46 | Professional | None | $194.98 | $1,698.24 | $7,079.46 |
Univera Setting Facility Modifier None Typical Low $186.21 Median $281.84 Typical High $3,235.94 | Facility | None | $186.21 | $281.84 | $3,235.94 |
Univera Setting Professional Modifier None Typical Low $1,659.59 Median $2,818.38 Typical High $3,548.13 | Professional | None | $1,659.59 | $2,818.38 | $3,548.13 |
5 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 $134.90 Median $1,621.81 Typical High $2,089.30 | Professional | 52 · Reduced service | $134.90 | $1,621.81 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $645.65 Typical High $831.76 | Professional | 53 · Discontinued | $53.70 | $645.65 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $2,398.83 Typical High $3,090.30 | Professional | 54 · Surgery only | $199.53 | $2,398.83 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $478.63 Typical High $616.60 | Professional | 55 · Aftercare only | $39.81 | $478.63 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $323.59 Typical High $416.87 | Professional | 56 · Pre-op care only | $26.92 | $323.59 | $416.87 |
Where New York sits
The same service costs 10.2 times more in Alaska than in Nebraska. 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· 25th of 51
$3,020
AK $5,012NE $490
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.