How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,000 to $10,000Professionalmedian $955 · 10th to 90th $776 to $1,479
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 $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,047.13 | $1,174.90 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,548.82 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,479.11 | Professional | None | $812.83 | $954.99 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $602.56 Typical High $912.01 | Professional | 62 · Two surgeons | $512.86 | $602.56 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $154.88 Typical High $234.42 | Professional | 80 · Assistant surgeon | $131.83 | $154.88 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $134.90 Typical High $204.17 | Professional | AS · PA/NP assist | $114.82 | $134.90 | $204.17 |
CDPHP Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $851.14 Median $851.14 Typical High $1,949.84 | Professional | None | $851.14 | $851.14 | $1,949.84 |
Emblem Health Setting Facility Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $3,890.45 | Facility | None | $1,071.52 | $1,288.25 | $3,890.45 |
Emblem Health Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $2,041.74 | Professional | None | $954.99 | $1,174.90 | $2,041.74 |
Excellus BCBS Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,348.96 | Professional | None | $676.08 | $933.25 | $1,348.96 |
MVP Health Care Setting Facility Modifier None Typical Low $933.25 Median $4,786.30 Typical High $5,754.40 | Facility | None | $933.25 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,174.90 | $1,621.81 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,165.95 | Facility | None | $575.44 | $1,778.28 | $6,165.95 |
United Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,513.56 | Professional | None | $707.95 | $954.99 | $1,513.56 |
Univera Setting Facility Modifier None Typical Low $630.96 Median $954.99 Typical High $3,311.31 | Facility | None | $630.96 | $954.99 | $3,311.31 |
Univera Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,348.96 | Professional | None | $676.08 | $933.25 | $1,348.96 |
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 $524.81 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $524.81 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $794.33 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $158.49 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $104.71 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $741.31 | $831.76 | $831.76 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $831.76 Typical High $1,202.26 | Professional | 54 · Surgery only | $489.78 | $831.76 | $1,202.26 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $93.33 Typical High $134.90 | Professional | 55 · Aftercare only | $53.70 | $93.33 | $134.90 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $83.18 Typical High $120.23 | Professional | 56 · Pre-op care only | $48.98 | $83.18 | $120.23 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $758.58 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $436.52 | $758.58 | $1,096.48 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $691.83 Typical High $954.99 | Professional | 53 · Discontinued | $524.81 | $691.83 | $954.99 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $831.76 Typical High $1,202.26 | Professional | 54 · Surgery only | $489.78 | $831.76 | $1,202.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $93.33 Typical High $194.98 | Professional | 55 · Aftercare only | $53.70 | $93.33 | $194.98 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $83.18 Typical High $173.78 | Professional | 56 · Pre-op care only | $48.98 | $83.18 | $173.78 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $758.58 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $436.52 | $758.58 | $1,096.48 |
Where New York sits
The same service costs 4.9 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· 45th of 51
$955
AK $3,548TX $724
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.