How much rates vary
Facilitymedian $4,898 · 10th to 90th $1,175 to $11,482Professionalmedian $4,266 · 10th to 90th $3,020 to $6,607
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 $4,570.88 Median $5,623.41 Typical High $5,623.41 | Professional | None | $4,570.88 | $5,623.41 | $5,623.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,456.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,630.78 Median $4,365.16 Typical High $6,606.93 | Professional | None | $3,630.78 | $4,365.16 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,290.87 Median $2,691.53 Typical High $4,168.69 | Professional | 62 · Two surgeons | $2,290.87 | $2,691.53 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $691.83 Typical High $1,047.13 | Professional | 80 · Assistant surgeon | $588.84 | $691.83 | $1,047.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $512.86 Median $602.56 Typical High $933.25 | Professional | AS · PA/NP assist | $512.86 | $602.56 | $933.25 |
CDPHP Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Professional | None | $6,309.57 | $6,309.57 | $6,309.57 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $7,413.10 | Facility | None | $851.14 | $1,778.28 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $8,912.51 | Professional | None | $3,801.89 | $3,801.89 | $8,912.51 |
Emblem Health Setting Facility Modifier None Typical Low $3,090.30 Median $5,128.61 Typical High $16,218.10 | Facility | None | $3,090.30 | $5,128.61 | $16,218.10 |
Emblem Health Setting Professional Modifier None Typical Low $4,168.69 Median $5,011.87 Typical High $8,709.64 | Professional | None | $4,168.69 | $5,011.87 | $8,709.64 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $3,801.89 Typical High $5,754.40 | Professional | None | $2,951.21 | $3,801.89 | $5,754.40 |
MVP Health Care Setting Facility Modifier None Typical Low $4,073.80 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,073.80 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $6,309.57 | Professional | None | $3,019.95 | $3,019.95 | $6,309.57 |
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 $3,019.95 Median $4,265.80 Typical High $6,760.83 | Professional | None | $3,019.95 | $4,265.80 | $6,760.83 |
Univera Setting Facility Modifier None Typical Low $2,818.38 Median $4,168.69 Typical High $11,481.54 | Facility | None | $2,818.38 | $4,168.69 | $11,481.54 |
Univera Setting Professional Modifier None Typical Low $2,951.21 Median $3,890.45 Typical High $5,754.40 | Professional | None | $2,951.21 | $3,890.45 | $5,754.40 |
15 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 $2,290.87 Median $2,818.38 Typical High $2,818.38 | Professional | 52 · Reduced service | $2,290.87 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $1,122.02 Typical High $1,122.02 | Professional | 53 · Discontinued | $933.25 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,467.37 Median $4,265.80 Typical High $4,265.80 | Professional | 54 · Surgery only | $3,467.37 | $4,265.80 | $4,265.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $691.83 Median $851.14 Typical High $851.14 | Professional | 55 · Aftercare only | $691.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $562.34 Typical High $562.34 | Professional | 56 · Pre-op care only | $457.09 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,235.94 Median $3,981.07 Typical High $3,981.07 | Professional | 78 · Unplanned return to OR | $3,235.94 | $3,981.07 | $3,981.07 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $3,548.13 Typical High $5,248.07 | Professional | 54 · Surgery only | $2,137.96 | $3,548.13 | $5,248.07 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $389.05 Typical High $575.44 | Professional | 55 · Aftercare only | $239.88 | $389.05 | $575.44 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $354.81 Typical High $524.81 | Professional | 56 · Pre-op care only | $213.80 | $354.81 | $524.81 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $3,162.28 Typical High $4,677.35 | Professional | 78 · Unplanned return to OR | $1,905.46 | $3,162.28 | $4,677.35 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $2,344.23 Median $3,162.28 Typical High $4,365.16 | Professional | 53 · Discontinued | $2,344.23 | $3,162.28 | $4,365.16 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $3,548.13 Typical High $5,248.07 | Professional | 54 · Surgery only | $2,137.96 | $3,548.13 | $5,248.07 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $389.05 Typical High $933.25 | Professional | 55 · Aftercare only | $239.88 | $389.05 | $933.25 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $354.81 Typical High $831.76 | Professional | 56 · Pre-op care only | $213.80 | $354.81 | $831.76 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $3,162.28 Typical High $4,677.35 | Professional | 78 · Unplanned return to OR | $1,905.46 | $3,162.28 | $4,677.35 |
Where New York sits
The same service costs 21.9 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· 41st of 51
$4,266
AK $15,136TX $692
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.