How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,175 to $13,183Professionalmedian $1,862 · 10th to 90th $1,445 to $3,715
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 $2,187.76 Median $2,187.76 Typical High $4,168.69 | Professional | None | $2,187.76 | $2,187.76 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $7,413.10 Typical High $14,454.40 | Facility | None | $1,659.59 | $7,413.10 | $14,454.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $3,388.44 | Professional | None | $1,479.11 | $1,778.28 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $288.40 Typical High $549.54 | Professional | 80 · Assistant surgeon | $239.88 | $288.40 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $251.19 Typical High $478.63 | Professional | AS · PA/NP assist | $208.93 | $251.19 | $478.63 |
CDPHP Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,090.30 | Facility | None | $851.14 | $1,778.28 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,905.46 Typical High $6,760.83 | Professional | None | $1,862.09 | $1,905.46 | $6,760.83 |
Emblem Health Setting Facility Modifier None Typical Low $2,137.96 Median $3,715.35 Typical High $7,244.36 | Facility | None | $2,137.96 | $3,715.35 | $7,244.36 |
Emblem Health Setting Professional Modifier None Typical Low $1,949.84 Median $2,238.72 Typical High $3,890.45 | Professional | None | $1,949.84 | $2,238.72 | $3,890.45 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,659.59 | $2,511.89 |
MVP Health Care Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
MVP Health Care Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $4,786.30 | Professional | None | $3,019.95 | $3,019.95 | $4,786.30 |
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 $1,479.11 Median $2,137.96 Typical High $5,495.41 | Professional | None | $1,479.11 | $2,137.96 | $5,495.41 |
Univera Setting Facility Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $6,456.54 | Facility | None | $1,288.25 | $1,698.24 | $6,456.54 |
Univera Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,659.59 | $2,511.89 |
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 $1,096.48 Median $1,096.48 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $489.78 | Professional | 53 · Discontinued | $436.52 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,659.59 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,659.59 | $1,659.59 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $331.13 Typical High $371.54 | Professional | 55 · Aftercare only | $331.13 | $331.13 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $245.47 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,548.82 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,548.82 | $1,737.80 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,548.82 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,122.02 | $1,548.82 | $2,454.71 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $114.82 Typical High $181.97 | Professional | 55 · Aftercare only | $85.11 | $114.82 | $181.97 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $147.91 Typical High $234.42 | Professional | 56 · Pre-op care only | $109.65 | $147.91 | $234.42 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,380.38 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,380.38 | $2,187.76 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,548.82 Typical High $2,454.71 | Professional | 54 · Surgery only | $1,122.02 | $1,548.82 | $2,454.71 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $117.49 Typical High $245.47 | Professional | 55 · Aftercare only | $85.11 | $117.49 | $245.47 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $147.91 Typical High $316.23 | Professional | 56 · Pre-op care only | $109.65 | $147.91 | $316.23 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,380.38 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,380.38 | $2,187.76 |
Where New York sits
The same service costs 6.3 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
$1,905
AK $7,413TX $1,175
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.