How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,148 to $14,125Professionalmedian $1,202 · 10th to 90th $977 to $2,512
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 $1,348.96 Median $1,348.96 Typical High $2,238.72 | Professional | None | $1,348.96 | $1,348.96 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $8,709.64 Typical High $15,135.61 | Facility | None | $1,737.80 | $8,709.64 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,174.90 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $741.31 Typical High $1,479.11 | Professional | 62 · Two surgeons | $630.96 | $741.31 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $371.54 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $165.96 Typical High $323.59 | Professional | AS · PA/NP assist | $141.25 | $165.96 | $323.59 |
CDPHP Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $1,258.93 Median $1,513.56 Typical High $4,677.35 | Professional | None | $1,258.93 | $1,513.56 | $4,677.35 |
Emblem Health Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $4,570.88 | Facility | None | $1,202.26 | $1,445.44 | $4,570.88 |
Emblem Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,513.56 | $2,454.71 |
Excellus BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,513.56 | Professional | None | $812.83 | $1,096.48 | $1,513.56 |
MVP Health Care Setting Facility Modifier None Typical Low $1,288.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,288.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,698.24 Median $1,778.28 Typical High $3,162.28 | Professional | None | $1,698.24 | $1,778.28 | $3,162.28 |
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 $954.99 Median $1,318.26 Typical High $3,630.78 | Professional | None | $954.99 | $1,318.26 | $3,630.78 |
Univera Setting Facility Modifier None Typical Low $870.96 Median $1,148.15 Typical High $4,168.69 | Facility | None | $870.96 | $1,148.15 | $4,168.69 |
Univera Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $1,445.44 | Professional | None | $812.83 | $1,096.48 | $1,445.44 |
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 $676.08 Median $676.08 Typical High $724.44 | Professional | 52 · Reduced service | $676.08 | $676.08 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $288.40 | Professional | 53 · Discontinued | $269.15 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $218.78 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,023.29 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $954.99 Typical High $1,412.54 | Professional | 54 · Surgery only | $691.83 | $954.99 | $1,412.54 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $154.88 Typical High $229.09 | Professional | 55 · Aftercare only | $114.82 | $154.88 | $229.09 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $109.65 Typical High $162.18 | Professional | 56 · Pre-op care only | $81.28 | $109.65 | $162.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $851.14 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $616.60 | $851.14 | $1,230.27 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $851.14 Typical High $1,202.26 | Professional | 53 · Discontinued | $616.60 | $851.14 | $1,202.26 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $954.99 Typical High $1,258.93 | Professional | 54 · Surgery only | $691.83 | $954.99 | $1,258.93 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $154.88 Typical High $331.13 | Professional | 55 · Aftercare only | $114.82 | $154.88 | $331.13 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $109.65 Typical High $234.42 | Professional | 56 · Pre-op care only | $81.28 | $109.65 | $234.42 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $851.14 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $616.60 | $851.14 | $1,148.15 |
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· 43rd of 51
$1,259
AK $4,898TX $724
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.