How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,072 to $13,183Professionalmedian $1,175 · 10th to 90th $891 to $2,291
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 $1,288.25 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,288.25 | $2,570.40 |
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 $933.25 Median $1,122.02 Typical High $2,089.30 | Professional | None | $933.25 | $1,122.02 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $707.95 Typical High $1,318.26 | Professional | 62 · Two surgeons | $588.84 | $707.95 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $177.83 Typical High $331.13 | Professional | 80 · Assistant surgeon | $147.91 | $177.83 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $154.88 Typical High $288.40 | Professional | AS · PA/NP assist | $128.82 | $154.88 | $288.40 |
CDPHP Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $1,174.90 Median $1,174.90 Typical High $4,168.69 | Professional | None | $1,174.90 | $1,174.90 | $4,168.69 |
Emblem Health Setting Facility Modifier None Typical Low $1,318.26 Median $2,511.89 Typical High $4,466.84 | Facility | None | $1,318.26 | $2,511.89 | $4,466.84 |
Emblem Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,380.38 | $2,290.87 |
Excellus BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,621.81 | Professional | None | $758.58 | $1,023.29 | $1,621.81 |
MVP Health Care Setting Professional Modifier None Typical Low $2,137.96 Median $2,187.76 Typical High $2,951.21 | Professional | None | $2,137.96 | $2,187.76 | $2,951.21 |
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 $933.25 Median $1,318.26 Typical High $3,388.44 | Professional | None | $933.25 | $1,318.26 | $3,388.44 |
Univera Setting Facility Modifier None Typical Low $812.83 Median $831.76 Typical High $4,677.35 | Facility | None | $812.83 | $831.76 | $4,677.35 |
Univera Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,621.81 | Professional | None | $758.58 | $1,023.29 | $1,621.81 |
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 $645.65 Median $645.65 Typical High $758.58 | Professional | 52 · Reduced service | $645.65 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $309.03 | Professional | 53 · Discontinued | $257.04 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $229.09 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,071.52 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $954.99 Typical High $1,548.82 | Professional | 54 · Surgery only | $707.95 | $954.99 | $1,548.82 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $72.44 Typical High $117.49 | Professional | 55 · Aftercare only | $52.48 | $72.44 | $117.49 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $91.20 Typical High $151.36 | Professional | 56 · Pre-op care only | $67.61 | $91.20 | $151.36 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $851.14 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $630.96 | $851.14 | $1,412.54 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $954.99 Typical High $1,513.56 | Professional | 54 · Surgery only | $707.95 | $954.99 | $1,513.56 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $72.44 Typical High $154.88 | Professional | 55 · Aftercare only | $52.48 | $72.44 | $154.88 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $93.33 Typical High $199.53 | Professional | 56 · Pre-op care only | $67.61 | $93.33 | $199.53 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $851.14 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $630.96 | $851.14 | $1,380.38 |
Where New York sits
The same service costs 5.6 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
$1,202
AK $4,571TX $813
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.