How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,202 to $14,125Professionalmedian $1,778 · 10th to 90th $1,349 to $3,467
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 $1,995.26 Median $1,995.26 Typical High $3,890.45 | Professional | None | $1,995.26 | $1,995.26 | $3,890.45 |
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 $1,412.54 Median $1,698.24 Typical High $3,162.28 | Professional | None | $1,412.54 | $1,698.24 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,071.52 Typical High $1,995.26 | Professional | 62 · Two surgeons | $891.25 | $1,071.52 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $269.15 Typical High $501.19 | Professional | 80 · Assistant surgeon | $223.87 | $269.15 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $239.88 Typical High $446.68 | Professional | AS · PA/NP assist | $199.53 | $239.88 | $446.68 |
CDPHP Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,884.03 | Facility | None | $851.14 | $1,778.28 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,819.70 Typical High $6,165.95 | Professional | None | $1,778.28 | $1,819.70 | $6,165.95 |
Emblem Health Setting Facility Modifier None Typical Low $1,995.26 Median $3,467.37 Typical High $6,760.83 | Facility | None | $1,995.26 | $3,467.37 | $6,760.83 |
Emblem Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $3,715.35 | Professional | None | $1,819.70 | $2,089.30 | $3,715.35 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,548.82 | $2,398.83 |
MVP Health Care Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
MVP Health Care Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $4,570.88 | Professional | None | $2,754.23 | $2,754.23 | $4,570.88 |
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 $1,412.54 Median $1,995.26 Typical High $5,248.07 | Professional | None | $1,412.54 | $1,995.26 | $5,248.07 |
Univera Setting Facility Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $9,549.93 | Facility | None | $1,230.27 | $1,621.81 | $9,549.93 |
Univera Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,148.15 | $1,548.82 | $2,398.83 |
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 $1,000.00 Median $1,000.00 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $467.74 | Professional | 53 · Discontinued | $398.11 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $346.74 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $234.42 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,621.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,445.44 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,071.52 | $1,445.44 | $2,290.87 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $107.15 Typical High $173.78 | Professional | 55 · Aftercare only | $81.28 | $107.15 | $173.78 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $138.04 Typical High $223.87 | Professional | 56 · Pre-op care only | $102.33 | $138.04 | $223.87 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,288.25 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $954.99 | $1,288.25 | $2,089.30 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,445.44 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,071.52 | $1,445.44 | $2,290.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $109.65 Typical High $234.42 | Professional | 55 · Aftercare only | $81.28 | $109.65 | $234.42 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $141.25 Typical High $302.00 | Professional | 56 · Pre-op care only | $102.33 | $141.25 | $302.00 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,318.26 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $954.99 | $1,318.26 | $2,089.30 |
Where New York sits
The same service costs 5.5 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· 45th of 51
$1,778
AK $6,918TX $1,259
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.