How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,148 to $14,125Professionalmedian $1,479 · 10th to 90th $1,122 to $2,884
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 $1,659.59 Median $1,659.59 Typical High $2,398.83 | Professional | None | $1,659.59 | $1,659.59 | $2,398.83 |
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 $1,174.90 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,174.90 | $1,412.54 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $891.25 Typical High $1,659.59 | Professional | 62 · Two surgeons | $741.31 | $891.25 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $229.09 Typical High $426.58 | Professional | 80 · Assistant surgeon | $186.21 | $229.09 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $199.53 Typical High $371.54 | Professional | AS · PA/NP assist | $165.96 | $199.53 | $371.54 |
CDPHP Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $1,479.11 Median $1,513.56 Typical High $5,128.61 | Professional | None | $1,479.11 | $1,513.56 | $5,128.61 |
Emblem Health Setting Facility Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $5,754.40 | Facility | None | $1,698.24 | $3,162.28 | $5,754.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $3,162.28 | Professional | None | $1,548.82 | $1,778.28 | $3,162.28 |
Excellus BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $2,089.30 | Professional | None | $954.99 | $1,318.26 | $2,089.30 |
MVP Health Care Setting Facility Modifier None Typical Low $1,737.80 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,737.80 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,691.53 Median $2,754.23 Typical High $3,801.89 | Professional | None | $2,691.53 | $2,754.23 | $3,801.89 |
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 $1,174.90 Median $1,698.24 Typical High $4,365.16 | Professional | None | $1,174.90 | $1,698.24 | $4,365.16 |
Univera Setting Facility Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $8,709.64 | Facility | None | $1,023.29 | $1,348.96 | $8,709.64 |
Univera Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $2,089.30 | Professional | None | $954.99 | $1,318.26 | $2,089.30 |
14 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 $831.76 Median $831.76 Typical High $977.24 | Professional | 52 · Reduced service | $831.76 | $831.76 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $389.05 | Professional | 53 · Discontinued | $331.13 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $295.12 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,348.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,230.27 Typical High $1,949.84 | Professional | 54 · Surgery only | $891.25 | $1,230.27 | $1,949.84 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $91.20 Typical High $147.91 | Professional | 55 · Aftercare only | $67.61 | $91.20 | $147.91 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $117.49 Typical High $190.55 | Professional | 56 · Pre-op care only | $87.10 | $117.49 | $190.55 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,096.48 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $812.83 | $1,096.48 | $1,778.28 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,230.27 Typical High $1,949.84 | Professional | 54 · Surgery only | $891.25 | $1,230.27 | $1,949.84 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $93.33 Typical High $194.98 | Professional | 55 · Aftercare only | $67.61 | $93.33 | $194.98 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $117.49 Typical High $251.19 | Professional | 56 · Pre-op care only | $87.10 | $117.49 | $251.19 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,096.48 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $812.83 | $1,096.48 | $1,737.80 |
Where New York sits
The same service costs 5.9 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
$1,514
AK $5,888TX $1,000
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.