How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,096 to $11,482Professionalmedian $1,549 · 10th to 90th $1,230 to $2,344
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 $1,621.81 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,949.84 | $1,949.84 |
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 $1,288.25 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,548.82 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $954.99 Typical High $1,479.11 | Professional | 62 · Two surgeons | $812.83 | $954.99 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $245.47 Typical High $371.54 | Professional | 80 · Assistant surgeon | $208.93 | $245.47 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $213.80 Typical High $323.59 | Professional | AS · PA/NP assist | $181.97 | $213.80 | $323.59 |
CDPHP Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
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 $1,348.96 Median $1,348.96 Typical High $3,162.28 | Professional | None | $1,348.96 | $1,348.96 | $3,162.28 |
Emblem Health Setting Facility Modifier None Typical Low $1,819.70 Median $2,398.83 Typical High $5,754.40 | Facility | None | $1,819.70 | $2,398.83 | $5,754.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,479.11 | $1,778.28 | $3,090.30 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,380.38 | $2,089.30 |
MVP Health Care Setting Facility Modifier None Typical Low $1,737.80 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,737.80 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,570.40 | Professional | None | $2,041.74 | $2,041.74 | $2,570.40 |
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 $1,122.02 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,513.56 | $2,398.83 |
Univera Setting Facility Modifier None Typical Low $977.24 Median $1,479.11 Typical High $7,244.36 | Facility | None | $977.24 | $1,479.11 | $7,244.36 |
Univera Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,380.38 | $2,089.30 |
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 $812.83 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $812.83 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $323.59 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,230.27 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $245.47 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $162.18 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,348.96 | $1,348.96 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,258.93 Typical High $1,862.09 | Professional | 54 · Surgery only | $758.58 | $1,258.93 | $1,862.09 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $138.04 Typical High $208.93 | Professional | 55 · Aftercare only | $83.18 | $138.04 | $208.93 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $125.89 Typical High $186.21 | Professional | 56 · Pre-op care only | $75.86 | $125.89 | $186.21 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,122.02 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $676.08 | $1,122.02 | $1,698.24 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $1,096.48 Typical High $1,513.56 | Professional | 53 · Discontinued | $831.76 | $1,096.48 | $1,513.56 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,258.93 Typical High $1,862.09 | Professional | 54 · Surgery only | $758.58 | $1,258.93 | $1,862.09 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $138.04 Typical High $302.00 | Professional | 55 · Aftercare only | $83.18 | $138.04 | $302.00 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $125.89 Typical High $269.15 | Professional | 56 · Pre-op care only | $75.86 | $125.89 | $269.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,122.02 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $676.08 | $1,122.02 | $1,698.24 |
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· 47th of 51
$1,549
AK $5,623TX $1,047
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.