How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,202 to $15,488Professionalmedian $3,802 · 10th to 90th $3,020 to $6,607
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 $3,715.35 Median $3,715.35 Typical High $6,309.57 | Professional | None | $3,715.35 | $3,715.35 | $6,309.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $20,892.96 | Facility | None | $1,862.09 | $8,709.64 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,235.94 Median $3,890.45 Typical High $6,165.95 | Professional | None | $3,235.94 | $3,890.45 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $630.96 Typical High $977.24 | Professional | 80 · Assistant surgeon | $524.81 | $630.96 | $977.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $457.09 Median $549.54 Typical High $851.14 | Professional | AS · PA/NP assist | $457.09 | $549.54 | $851.14 |
CDPHP Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $5,623.41 | Facility | None | $851.14 | $1,778.28 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $11,481.54 | Professional | None | $3,467.37 | $3,467.37 | $11,481.54 |
Emblem Health Setting Facility Modifier None Typical Low $3,548.13 Median $5,623.41 Typical High $12,302.69 | Facility | None | $3,548.13 | $5,623.41 | $12,302.69 |
Emblem Health Setting Professional Modifier None Typical Low $3,467.37 Median $4,073.80 Typical High $7,079.46 | Professional | None | $3,467.37 | $4,073.80 | $7,079.46 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $3,019.95 Typical High $4,786.30 | Professional | None | $2,238.72 | $3,019.95 | $4,786.30 |
MVP Health Care Setting Facility Modifier None Typical Low $4,073.80 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,073.80 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $8,709.64 | Professional | None | $3,090.30 | $3,090.30 | $8,709.64 |
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 $2,691.53 Median $3,890.45 Typical High $10,232.93 | Professional | None | $2,691.53 | $3,890.45 | $10,232.93 |
Univera Setting Facility Modifier None Typical Low $2,344.23 Median $3,162.28 Typical High $5,248.07 | Facility | None | $2,344.23 | $3,162.28 | $5,248.07 |
Univera Setting Professional Modifier None Typical Low $2,238.72 Median $3,019.95 Typical High $4,786.30 | Professional | None | $2,238.72 | $3,019.95 | $4,786.30 |
17 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 $1,862.09 Median $1,862.09 Typical High $2,238.72 | Professional | 52 · Reduced service | $1,862.09 | $1,862.09 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $741.31 Median $741.31 Typical High $912.01 | Professional | 53 · Discontinued | $741.31 | $741.31 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $2,818.38 Typical High $3,388.44 | Professional | 54 · Surgery only | $2,818.38 | $2,818.38 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $562.34 Typical High $676.08 | Professional | 55 · Aftercare only | $562.34 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $371.54 Typical High $446.68 | Professional | 56 · Pre-op care only | $371.54 | $371.54 | $446.68 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,754.23 Typical High $4,570.88 | Professional | 54 · Surgery only | $2,041.74 | $2,754.23 | $4,570.88 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $208.93 Typical High $346.74 | Professional | 55 · Aftercare only | $154.88 | $208.93 | $346.74 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $269.15 Typical High $446.68 | Professional | 56 · Pre-op care only | $199.53 | $269.15 | $446.68 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,511.89 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,511.89 | $4,168.69 |
Univera Setting Facility Modifier 54 · Surgery only Typical Low $2,187.76 Median $3,090.30 Typical High $3,981.07 | Facility | 54 · Surgery only | $2,187.76 | $3,090.30 | $3,981.07 |
Univera Setting Facility Modifier 55 · Aftercare only Typical Low $165.96 Median $257.04 Typical High $302.00 | Facility | 55 · Aftercare only | $165.96 | $257.04 | $302.00 |
Univera Setting Facility Modifier 56 · Pre-op care only Typical Low $213.80 Median $331.13 Typical High $389.05 | Facility | 56 · Pre-op care only | $213.80 | $331.13 | $389.05 |
Univera Setting Facility Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $3,090.30 Typical High $3,630.78 | Facility | 78 · Unplanned return to OR | $1,995.26 | $3,090.30 | $3,630.78 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,818.38 Typical High $4,466.84 | Professional | 54 · Surgery only | $2,041.74 | $2,818.38 | $4,466.84 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $213.80 Typical High $436.52 | Professional | 55 · Aftercare only | $154.88 | $213.80 | $436.52 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $269.15 Typical High $549.54 | Professional | 56 · Pre-op care only | $199.53 | $269.15 | $549.54 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,511.89 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,511.89 | $3,981.07 |
Where New York sits
The same service costs 7.4 times more in Alaska than in Arkansas. 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· 35th of 51
$3,802
AK $13,490AR $1,820
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.