How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,148 to $14,125Professionalmedian $1,259 · 10th to 90th $955 to $2,455
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 $1,412.54 Median $1,412.54 Typical High $3,090.30 | Professional | None | $1,412.54 | $1,412.54 | $3,090.30 |
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 $1,000.00 Median $1,202.26 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,202.26 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $758.58 Typical High $1,445.44 | Professional | 62 · Two surgeons | $630.96 | $758.58 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $190.55 Typical High $363.08 | Professional | 80 · Assistant surgeon | $158.49 | $190.55 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $165.96 Typical High $316.23 | Professional | AS · PA/NP assist | $138.04 | $165.96 | $316.23 |
CDPHP Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
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 $1,258.93 Median $1,288.25 Typical High $4,466.84 | Professional | None | $1,258.93 | $1,288.25 | $4,466.84 |
Emblem Health Setting Facility Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $4,677.35 | Facility | None | $1,445.44 | $1,737.80 | $4,677.35 |
Emblem Health Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,513.56 | $2,691.53 |
Excellus BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,778.28 | Professional | None | $812.83 | $1,122.02 | $1,778.28 |
MVP Health Care Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
MVP Health Care Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $3,162.28 | Professional | None | $2,187.76 | $2,187.76 | $3,162.28 |
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 $1,000.00 Median $1,445.44 Typical High $3,630.78 | Professional | None | $1,000.00 | $1,445.44 | $3,630.78 |
Univera Setting Facility Modifier None Typical Low $870.96 Median $1,148.15 Typical High $5,754.40 | Facility | None | $870.96 | $1,148.15 | $5,754.40 |
Univera Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $1,778.28 | Professional | None | $812.83 | $1,122.02 | $1,778.28 |
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 $691.83 Median $691.83 Typical High $831.76 | Professional | 52 · Reduced service | $691.83 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | 53 · Discontinued | $281.84 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $245.47 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,148.15 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,047.13 Typical High $1,698.24 | Professional | 54 · Surgery only | $758.58 | $1,047.13 | $1,698.24 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $77.62 Typical High $125.89 | Professional | 55 · Aftercare only | $57.54 | $77.62 | $125.89 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $100.00 Typical High $162.18 | Professional | 56 · Pre-op care only | $74.13 | $100.00 | $162.18 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $933.25 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $691.83 | $933.25 | $1,513.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,047.13 Typical High $1,621.81 | Professional | 54 · Surgery only | $758.58 | $1,047.13 | $1,621.81 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $77.62 Typical High $165.96 | Professional | 55 · Aftercare only | $57.54 | $77.62 | $165.96 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $100.00 Typical High $213.80 | Professional | 56 · Pre-op care only | $74.13 | $100.00 | $213.80 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $933.25 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $691.83 | $933.25 | $1,479.11 |
Where New York sits
The same service costs 5.4 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
$1,288
AK $5,012TX $933
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.