How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,148 to $10,233Professionalmedian $3,715 · 10th to 90th $2,951 to $5,623
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 $4,073.80 Median $4,168.69 Typical High $4,168.69 | Professional | None | $4,073.80 | $4,168.69 | $4,168.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,715.19 | Facility | None | $1,548.82 | $4,466.84 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $3,715.35 Typical High $5,888.44 | Professional | None | $3,162.28 | $3,715.35 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,995.26 Median $2,344.23 Typical High $3,548.13 | Professional | 62 · Two surgeons | $1,995.26 | $2,344.23 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $588.84 Typical High $891.25 | Professional | 80 · Assistant surgeon | $501.19 | $588.84 | $891.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $446.68 Median $524.81 Typical High $776.25 | Professional | AS · PA/NP assist | $446.68 | $524.81 | $776.25 |
CDPHP Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,495.41 | $5,495.41 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $6,456.54 | Facility | None | $851.14 | $1,778.28 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $7,244.36 | Professional | None | $3,311.31 | $3,311.31 | $7,244.36 |
Emblem Health Setting Facility Modifier None Typical Low $3,311.31 Median $4,466.84 Typical High $14,454.40 | Facility | None | $3,311.31 | $4,466.84 | $14,454.40 |
Emblem Health Setting Professional Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $7,585.78 | Professional | None | $4,365.16 | $4,365.16 | $7,585.78 |
Excellus BCBS Setting Professional Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $5,128.61 | Professional | None | $2,570.40 | $3,311.31 | $5,128.61 |
MVP Health Care Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $5,754.40 | Facility | None | $4,786.30 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $6,025.60 | Professional | None | $3,019.95 | $3,019.95 | $6,025.60 |
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 $2,691.53 Median $3,715.35 Typical High $5,888.44 | Professional | None | $2,691.53 | $3,715.35 | $5,888.44 |
Univera Setting Facility Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $12,589.25 | Facility | None | $2,454.71 | $2,884.03 | $12,589.25 |
Univera Setting Professional Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $5,128.61 | Professional | None | $2,570.40 | $3,311.31 | $5,128.61 |
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 $2,041.74 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $2,041.74 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $812.83 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,162.28 Typical High $3,162.28 | Professional | 54 · Surgery only | $3,019.95 | $3,162.28 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | 55 · Aftercare only | $602.56 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $416.87 Typical High $416.87 | Professional | 56 · Pre-op care only | $407.38 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $2,951.21 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $2,818.38 | $2,951.21 | $2,951.21 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $3,090.30 Typical High $4,677.35 | Professional | 54 · Surgery only | $1,862.09 | $3,090.30 | $4,677.35 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $338.84 Typical High $512.86 | Professional | 55 · Aftercare only | $208.93 | $338.84 | $512.86 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $309.03 Typical High $467.74 | Professional | 56 · Pre-op care only | $186.21 | $309.03 | $467.74 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,754.23 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,754.23 | $4,168.69 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $2,041.74 Median $2,691.53 Typical High $3,548.13 | Professional | 53 · Discontinued | $2,041.74 | $2,691.53 | $3,548.13 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $3,090.30 Typical High $4,677.35 | Professional | 54 · Surgery only | $1,862.09 | $3,090.30 | $4,677.35 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $338.84 Typical High $758.58 | Professional | 55 · Aftercare only | $208.93 | $338.84 | $758.58 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $309.03 Typical High $676.08 | Professional | 56 · Pre-op care only | $186.21 | $309.03 | $676.08 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $2,754.23 Typical High $4,168.69 | Professional | 78 · Unplanned return to OR | $1,698.24 | $2,754.23 | $4,168.69 |
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
$3,715
AK $13,183TX $603
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.