How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,047 to $11,749Professionalmedian $1,122 · 10th to 90th $912 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 $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $2,041.74 | Professional | None | $1,230.27 | $1,230.27 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $6,760.83 Typical High $12,882.50 | Facility | None | $1,778.28 | $6,760.83 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $2,137.96 | Professional | None | $933.25 | $1,096.48 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $691.83 Typical High $1,348.96 | Professional | 62 · Two surgeons | $588.84 | $691.83 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $173.78 Typical High $346.74 | Professional | 80 · Assistant surgeon | $147.91 | $173.78 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $302.00 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $302.00 |
CDPHP Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $4,365.16 | Professional | None | $1,148.15 | $1,412.54 | $4,365.16 |
Emblem Health Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $4,365.16 | Facility | None | $1,148.15 | $1,348.96 | $4,365.16 |
Emblem Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,412.54 | $2,344.23 |
Excellus BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,412.54 | Professional | None | $758.58 | $1,047.13 | $1,412.54 |
MVP Health Care Setting Facility Modifier None Typical Low $1,148.15 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,148.15 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,174.90 | $2,818.38 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $3,311.31 | Professional | None | $870.96 | $1,202.26 | $3,311.31 |
Univera Setting Facility Modifier None Typical Low $812.83 Median $1,047.13 Typical High $3,715.35 | Facility | None | $812.83 | $1,047.13 | $3,715.35 |
Univera Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $1,412.54 | Professional | None | $758.58 | $1,047.13 | $1,412.54 |
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 $616.60 Median $616.60 Typical High $676.08 | Professional | 52 · Reduced service | $616.60 | $616.60 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $269.15 | Professional | 53 · Discontinued | $245.47 | $245.47 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $199.53 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $134.90 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $933.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $891.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $645.65 | $891.25 | $1,318.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $147.91 Typical High $213.80 | Professional | 55 · Aftercare only | $104.71 | $147.91 | $213.80 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $104.71 Typical High $154.88 | Professional | 56 · Pre-op care only | $75.86 | $104.71 | $154.88 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $794.33 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $575.44 | $794.33 | $1,174.90 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $776.25 Typical High $1,122.02 | Professional | 53 · Discontinued | $575.44 | $776.25 | $1,122.02 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $891.25 Typical High $1,202.26 | Professional | 54 · Surgery only | $645.65 | $891.25 | $1,202.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $147.91 Typical High $309.03 | Professional | 55 · Aftercare only | $104.71 | $147.91 | $309.03 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $104.71 Typical High $218.78 | Professional | 56 · Pre-op care only | $75.86 | $104.71 | $218.78 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $794.33 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $575.44 | $794.33 | $1,071.52 |
Where New York sits
The same service costs 6.8 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
$1,148
AK $4,571TX $676
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.