How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,096 to $11,220Professionalmedian $1,380 · 10th to 90th $1,122 to $2,138
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 $1,513.56 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,737.80 | $1,737.80 |
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 $1,174.90 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,380.38 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $870.96 Typical High $1,348.96 | Professional | 62 · Two surgeons | $741.31 | $870.96 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $223.87 Typical High $346.74 | Professional | 80 · Assistant surgeon | $190.55 | $223.87 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $194.98 Typical High $302.00 | Professional | AS · PA/NP assist | $165.96 | $194.98 | $302.00 |
CDPHP Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Professional | None | $2,041.74 | $2,041.74 | $2,041.74 |
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 $1,230.27 Median $1,230.27 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,230.27 | $2,884.03 |
Emblem Health Setting Facility Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $5,495.41 | Facility | None | $1,513.56 | $1,949.84 | $5,495.41 |
Emblem Health Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $2,951.21 | Professional | None | $1,348.96 | $1,659.59 | $2,951.21 |
Excellus BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,905.46 | Professional | None | $954.99 | $1,318.26 | $1,905.46 |
MVP Health Care Setting Facility Modifier None Typical Low $1,479.11 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,479.11 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,479.11 | $1,479.11 | $2,344.23 |
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 $1,023.29 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,380.38 | $2,187.76 |
Univera Setting Facility Modifier None Typical Low $912.01 Median $1,348.96 Typical High $5,248.07 | Facility | None | $912.01 | $1,348.96 | $5,248.07 |
Univera Setting Professional Modifier None Typical Low $954.99 Median $1,318.26 Typical High $1,905.46 | Professional | None | $954.99 | $1,318.26 | $1,905.46 |
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 $758.58 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $758.58 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $302.00 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,122.02 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $223.87 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $151.36 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,230.27 | $1,230.27 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,202.26 Typical High $1,737.80 | Professional | 54 · Surgery only | $707.95 | $1,202.26 | $1,737.80 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $131.83 Typical High $190.55 | Professional | 55 · Aftercare only | $77.62 | $131.83 | $190.55 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $120.23 Typical High $173.78 | Professional | 56 · Pre-op care only | $70.79 | $120.23 | $173.78 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,071.52 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $630.96 | $1,071.52 | $1,548.82 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $1,000.00 Typical High $1,380.38 | Professional | 53 · Discontinued | $758.58 | $1,000.00 | $1,380.38 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,202.26 Typical High $1,737.80 | Professional | 54 · Surgery only | $707.95 | $1,202.26 | $1,737.80 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $131.83 Typical High $281.84 | Professional | 55 · Aftercare only | $77.62 | $131.83 | $281.84 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $120.23 Typical High $251.19 | Professional | 56 · Pre-op care only | $70.79 | $120.23 | $251.19 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $1,071.52 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $630.96 | $1,071.52 | $1,548.82 |
Where New York sits
The same service costs 5.0 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· 46th of 51
$1,380
AK $5,012TX $1,000
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.